bluuebunny/crossref_metadata_2025 huggingface dataset:
Politics and Social Visions
Authors: Ferrera Maurizio
Published: April 2024

During the 2010s the European Union entered into an existential predicament. The Euro crisis triggered a sharp conflict between a frugal North and a solidaristic South. The refugee crisis pitted the sovereigntist view of most Central and Eastern member states against the ‘burden sharing’ view of the others. Brexit sealed the victory of Euroscepticism. Divides intensified within the Left camp regarding the very desirability of a Social Europe. How can we explain this spiral of centrifugation? The book argues that the key cause was a long-standing but suddenly accelerating deficit of ‘communal ethos’ among the member states. A deficit caused by the failure of the main ideological families of the Continent to elaborate coherent visions about the EU as a compound community of national welfare states . Ideological pluralism is vital for the dynamism of a polity. But in order to avert destructive conflict, ideological visions must incorporate the values of common belonging, a shared allegiance to the group as such, capable of favouring mutual adjustments and compromises, especially in the face of adversities. Only with the Covid 19 pandemic has a basic communal consensus (re)emerged, mitigating ideological divides and allowing for a solidaristic re-orientation of the EU polity.
Can Artificial Intelligence Bring Deliberation to the Masses?
Authors: Landemore Hélène
Published: April 2024

A core problem in deliberative democracy is the tension between two seemingly equally important conditions of democratic legitimacy: deliberation, on the one hand, and mass participation, on the other. Might artificial intelligence help bring quality deliberation to the masses? The answer is a qualified yes. The chapter first examines the conundrum in deliberative democracy around the trade-off between deliberation and mass participation by returning to the seminal debate between Joshua Cohen and Jürgen Habermas. It then turns to an analysis of the 2019 French Great National Debate, a low-tech attempt to involve millions of French citizens in a two-month-long structured exercise of collective deliberation. Building on the shortcomings of this process, the chapter then considers two different visions for an algorithm-powered form of mass deliberation—Mass Online Deliberation (MOD), on the one hand, and Many Rotating Mini-publics (MRMs), on the other—theorizing various ways artificial intelligence could play a role in them. To the extent that artificial intelligence makes the possibility of either vision more likely to come to fruition, it carries with it the promise of deliberation at the very large scale.
Intersection Is Not Identity, or How to Distinguish Overlapping Systems of Injustice
Authors: Dembroff Robin
Published: April 2024

When one takes an intersectional perspective on patterns of oppression and domination, it becomes clear that familiar forms of systemic injustice, such as misogyny and anti-Black racism, are inseparable. Some feminist theorists conclude, from this, that the systems behind these injustices cannot be individuated—for example, that there isn’t patriarchy and white supremacy, but instead only white supremacist patriarchy. This chapter offers a different perspective. Philosophers have long observed that a statue and a lump of clay can be individuated although inseparable, and that statues and lumps of clay do different explanatory and predictive work for the same causal outcomes. This chapter suggests that the same is true of systems such as patriarchy and white supremacy. These systems, like the injustices they produce, are inseparable. But they can be individuated, and when they are individuated, they do different explanatory and predictive work.
Buffering the Great Recession and the eurozone crisis
Authors: Matsaganis Manos , Parma Andrea
Published: April 2024

In this chapter, we investigate the empirical record on the role of welfare buffers during the Great Recession and the eurozone crisis. Specifically, we review the evidence on the performance of automatic stabilizers and discretionary policy changes, and we present the results of our work on how effectively social benefits softened the blow of job and income loss in twelve European countries. We find that Europe’s welfare states responded to the crisis as prescribed: when earnings fell, social benefits were there to cushion the blow. Nonetheless, there were exceptions. In southern and eastern Europe, automatic stabilizers had been weaker to start with, and were further undermined by austerity: social spending was retrenched pro-cyclically, just as the economy contracted and unemployment rolls grew. Welfare buffers were deployed most effectively in countries with inclusive social protection systems, typically embedded in economies enjoying greater fiscal space, free from the constraints of external supervision.
The legacy of the eurozone crisis
Authors: Hemerijck Anton , Matsaganis Manos
Published: April 2024

In this chapter we offer a brief exposition of the EU’s policy response to the eurozone crisis. We find that the resolve of policymakers at the periphery to keep their countries in the euro area (even when it meant electoral suicide), the willingness of voters there to put up with bitter medicine (if that was the price of EMU membership), and the commitment of core countries to the integrity of the eurozone (albeit grudging and at times verging on vengeful) were all decisive. Moreover, macroeconomic governance in the eurozone has evolved considerably from the immediate reaction to the crisis, and has advanced by leaps and bounds since 2020. Still, a bias persists in EMU governance, with fiscal imbalances being more stringently defined and less leniently treated than macroeconomic imbalances, while the banking union remains incomplete without a common deposit-insurance system and a fiscal backstop to the Single Resolution Mechanism.
Why Natural Social Contracts Are Not Fair
Authors: O’Connor Cailin
Published: April 2024

Game theory has been employed to model the emergence of stable social norms, or natural “social contracts.” One branch of this literature uses bargaining games to show why many societies have norms and rules for fairness. In cultural evolutionary models, fair bargaining emerges endogenously, because it is an efficient way to divide resources. These models, however, miss an important element of real human societies—divisions into groups or social categories. Once these factors are added, fairness is no longer the expected outcome. Instead “discriminatory norms” often emerge where one group systematically gets more when dividing resources, which helps explain why categorical inequity is the rule in human societies. If one wishes to understand the naturalistic emergence of social contracts, one must account for the presence of categorical divisions, and unfairness, as well as for norms of fairness. This chapter overviews this body of work and considers its lessons for social contract theory.
The Economics of the UK Health and Social Care Labour Market
Authors: Elliott Robert
Published: April 2024

In 2019, three million workers delivered health and social care in the UK; they accounted for one in every ten workers. These frontline workers delivered the spectrum of care we receive ‘from the cradle to the grave’; they are the occupations we encounter in hospitals, community health care, residential, and domiciliary care settings. Fifty per cent of the current spend of a typical UK hospital goes on its frontline workforce, and yet policy toward this workforce bears little evidence of being based on sound research. This book details the size, occupational composition, geographical spread, and growth of this workforce. It identifies the reasons people work in frontline care and what drives the demand for these workers. It explains how the UK labour market is part of a global market and details the heavy dependence of the UK on foreign trained workers. It explains how the labour market for frontline workers operates, how these workers’ pay is set, what has happened to their pay in recent years, and why there are such acute shortages of some of the key frontline occupations. It employs economic theory to analyse this labour market and presents the analytic framework required to construct coherent policy. Finally, it offers a number of proposals for policy to improve the efficiency with which this market operates and to address current problems.
Animalization
Authors: de Ruiter Adrienne
Published: April 2024

What does it mean to deny people’s humanity by regarding, portraying, or treating them as animals? This question is explored in this chapter, which examines the so-called ‘animalization’ of refugees, asylum seekers, and unwanted migrants. Considering various ways in which (forcibly) displaced persons are identified with animals, this chapter examines how each of these relates to dehumanization. A close look at animalization shows that the act of likening people to animals is not always morally problematic, let alone dehumanizing. Central to dehumanizing forms of animalization is the idea that the distinctively human quality of the feelings, thoughts, and life of the person(s) involved is discredited by attributing to it a lower, animalistic, status. The chapter’s main argument is that the moral sense of humanity is central to understanding the point at which animalization turns into dehumanization, as this occurs when victims are viewed, portrayed, or treated as less than human in a normative sense.
Property
Authors: Briggs Adrian
Published: April 2024

In this chapter the private international law of property is examined in relation to immovable property (jurisdiction and applicable law; the rules in Moçambique and Penn v Baltimore); tangible movable property (things); intangible movable property (credits/debts, contractual rights, assignments, shares, indirectly held securities); new forms of property (or not) of the crypto- kind. Particular transactions relating to property are also examined: governmental seizure; judicial seizure; and the effect of marriage, divorce and death on property. The chapter also discusses the extent to which the retained Rome I Regulation may apply to transactions concerning intangible property, and the retained Rome II Regulation to tangible property.
Introduction
Authors: Peters Anne , Sparks Tom
Published: April 2024

The introductory chapter presents the thesis that international law is reorienting to centre the individual (the ‘humanisation’ of international law) and defines its key concepts for the purposes of the discussion to follow. It outlines the development of humanisation in the literature to date, and seeks to refine the scope and depth of humanisation through discussion of human rights, rights beyond human rights, international individual legal personality, and State sovereignty. It then outlines the major critiques of humanisation, including three ‘productive’ critiques: that humanisation is neoliberal; that it is neocolonial; and that it is anthropocentric. It highlights that many critiques of humanisation focus on its perceived lack of a historical and theoretical grounding, and demonstrates the need for a history and theory of the individual in international law. The chapter concludes by briefly outlining the structure of the volume.
The Individual in Secular Natural Law Theories of International Law
Authors: Sparks Tom
Published: April 2024

The secular tradition of natural law founds law and morality on philosophical precepts rather than divine truth. As such, it has often—though need not necessarily—used human values as the starting point for legal theory, and as a result is often seen as a natural counterpart to the humanisation thesis. This chapter investigates the link between humanisation and secular natural law in order to show that a system of international law built on natural law foundations would, at least according to the vast majority of secular natural law theories, be a ‘humanised’ legal system. The chapter then addresses the sceptical challenge to secular natural law, and asks whether a natural law-based ‘humanised’ international legal system could be built from sceptical foundations. It relies on the socio-legal theory of Émile Durkheim to argue that even if the sceptical premise is granted, the international legal system must nevertheless be individual-centred.
Conclusions
Authors: Peters Anne , Sparks Tom
Published: April 2024

The concluding chapter brings together the key findings from each part of the volume, and suggests a forward research agenda for scholars of the individual in international law. It first summarises the chapters in the historical and theoretical parts of the book in order to highlight key lessons, overlaps, and contrasts. It then reassesses the key critiques of humanisation in light of the analysis in the various contributions, and demonstrates that the majority of the critiques are answered by a historical and theoretical analysis. The chapter then returns to the three ‘productive’ critiques highlighted in the introduction, namely, that humanisation is neoliberal, neocolonial, and anthropocentric, and argues for open-minded reflection. There is a need to distinguish between humanisation and individualisation, in order to create space for the humanisation thesis to engage with ecocentrism and posthumanism, as well as to better situate individuals within communities and social contexts. Doing so, it argues, will create space for a renewed, ‘second wave’ individual-centred approach to international law.
The Thought of Bal Gangadhar Tilak
Authors: Upton Robert E.
Published: April 2024

This work offers a systematic study of Bal Gangadhar Tilak’s thought, focusing on his views on ‘communal’ relations within the Indian polity, on caste and reform in Hindu society, and on political ethics regarding violence and non-cooperation. It adopts a contextualist approach, situating Tilak’s ideas in local Maharashtrian as well as all-Indian and global cultural-intellectual contexts. The approach blends Tilak’s quotidian journalism and speeches alongside his canonical texts on Aryan history and on the Bhagavad Gita. The work marks a departure from current interpretations, emphatically arguing that Tilak is misappropriated and/or misunderstood as a proto-Hindutva thinker. Tilak instead emerges as a majoritarian pluralist in inter-community terms, a radical liberal in his espousal of counter-autocratic violence, and both self-strengthening, masculinity-focused reformer and Brahmin supremacist, substantially hemmed in by nineteenth-century frameworks while self-consciously committed to refashioning India for the challenges of modernity. The work also studies Tilak’s contesting and reworking in India’s public sphere since his death, in turn helping to situate the range of historiographical responses to him. Underlining Tilak’s remarkable hailing as a national ‘founding father’ from 1920, it particularly shows how Tilak’s subsequent appropriation by Gandhi was contested by those celebrating Tilak’s violence to oppose him, in the crucial mid-1920s period when Tilak was enduringly connected to re-emergent Hindutva. More recently, a growing ahistorical demi-official insistence on his social progressivism illustrates a change in India’s public culture—as does the use of popular or even legal pressure to delegitimate perennial criticism of Tilak’s socio-political positions.
The Nature of the Indian Polity
Authors: Upton Robert E.
Published: April 2024

The chapter focuses on Tilak’s communitarian vision, consistent from the aftermath of the Hindu-Muslim Bombay riots of 1893 and still present in his response to the Khilafat agitation at the end of his life, in which the polity was a site of competing, enumerated, primordial religious communities: his concern for the consolidation of the Hindus of western India within this framework prompted his promotion of the festival in honour of the elephant-headed deity Ganesh in Maharashtra in the mid-1890s—and ultimately occasioned his reflections on the unifying characteristics of the Hindu religion which would underpin the Indian Supreme Court understanding of Hinduism in the post-independence period. The chapter will also consider the problematic nature of Tilak’s attempts, hemmed in by his Maharashtrian Hindu antecedents and imaginative resources, to fashion all-Indian nationalist symbols, focusing on his celebration of the seventeenth-century warrior-king Shivaji as far afield as Bengal in the early 1900s. Lastly, it will consider Tilak’s conception of the ultimate origin of legitimate political authority in representative government, influenced by English radical and liberal thought in the language of political ‘birthright’, as well as precolonial Maharashtrian political history, and resting on his Vedantic understanding of the self.
Introduction
Authors: Michie Ranald C.
Published: April 2024

Judged by turnover the foreign exchange market is the largest in the world. Though considered a recent development dating from the 1970s, the foreign exchange market has a long history. Even under the Gold Standard, which operated before the First World War, an active foreign exchange market existed. That market then grew in importance between the two world wars, fuelled by currency instability. After the Second World War there was an attempt to introduce fixed exchange rates managed by central banks. That attempt marginalized the foreign exchange market but collapsed in the 1970s, to be replaced by a flourishing foreign exchange market. At the heart of that market was the City of London, despite being eclipsed by New York, as a global financial centre and the replacement of the UK£ by the US$ as an international currency.
Conclusion
Authors: Michie Ranald C.
Published: April 2024

Two conclusions emerge. The first is that the City of London has been the centre of the global foreign exchange market for, at least, the last 150 years. New York had the opportunity to replace London in the decades after the Second World War but failed to take it. That left London well-placed to revive its role after 1970. The second conclusion is that the foreign exchange market was always there to provide a solution to the world’s quest for currency stability. The problem was that it went either unrecognized (before 1914), dismissed (1919–39), or marginalized (1950–70). It was only after 1970 that it emerged from the shadows, but even then it failed to be given the credit it deserved.
The Art and Business of Songwriting
Authors: Batiste Larry D.
Published: April 2024

In The Art and Business of Songwriting, veteran songwriter, producer, arranger, vocalist, music director, and educator Larry D. Batiste shares years of experience in this valuable resource guide for both beginners and professionals who are interested in learning how to improve their songwriting skills. This book offers an opportunity for the reader to learn and apply the craft of professional songwriting including song structure, lyric and melody writing, and integration of essential elements found in hit songs. This book incorporates exercises that will help songwriters find ideas for song titles, concepts, stories, and effective word choices that will appeal to their audience. The book also discusses critical business aspects of songwriting, such as copyrighting, publishing, royalties, networking, and digital media income. In addition to the fundamentals of songwriting and business the reader will learn how to build a songwriting career, song placement techniques, building an online community, releasing music independently, the business of digital music, building a fanbase, and strategic planning. The book includes interviews from iconic songwriters and producers such as Peter Asher, Lamont Dozier, and Narada Michael Walden, among others; plus, independent recording artists, including multiple Grammy Award winner Fantastic Negrito and Meklit Hadero. Possessing knowledge in both artistic and business aspects of songwriting is essential for a successful career in the music industry. The information in this book applies to every genre of popular music and is written in a manner that encourages, motivates, and unlocks idiosyncrasies for music professionals as well as music enthusiasts.
Astronomy’s climate emissions: Global travel to scientific meetings in 2019
Authors: Gokus Andrea , Jahnke Knud , Woods Paul M , Moss Vanessa A , Ossenkopf-Okada Volker , Sacchi Elena , Stevens Adam R H , Burtscher Leonard , Kayhan Cenk , Dalgleish Hannah , Grinberg Victoria , Rector Travis A , Rybizki Jan , White Jacob
Published: April 2024

Travel to academic conferences—where international flights are the norm—is responsible for a sizeable fraction of the greenhouse gas (GHG) emissions associated with academic work. In order to provide a benchmark for comparison with other fields, as well as for future reduction strategies and assessments, we estimate the CO2-equivalent emissions for conference travel in the field of astronomy for the prepandemic year 2019. The GHG emission of the international astronomical community’s 362 conferences and schools in 2019 amounted to 42,500 tCO2e, assuming a radiative-forcing index factor of 1.95 for air travel. This equates to an average of 1.0 ± 0.6 tCO2e per participant per meeting. The total travel distance adds up to roughly 1.5 Astronomical Units, that is, 1.5 times the distance between the Earth and the Sun. We present scenarios for the reduction of this value, for instance with virtual conferencing or hub models, while still prioritizing the benefits conferences bring to the scientific community.
Continuous tracking using deep learning-based decoding for noninvasive brain–computer interface
Authors: Forenzo Dylan , Zhu Hao , Shanahan Jenn , Lim Jaehyun , He Bin
Published: April 2024

Brain–computer interfaces (BCI) using electroencephalography provide a noninvasive method for users to interact with external devices without the need for muscle activation. While noninvasive BCIs have the potential to improve the quality of lives of healthy and motor-impaired individuals, they currently have limited applications due to inconsistent performance and low degrees of freedom. In this study, we use deep learning (DL)-based decoders for online continuous pursuit (CP), a complex BCI task requiring the user to track an object in 2D space. We developed a labeling system to use CP data for supervised learning, trained DL-based decoders based on two architectures, including a newly proposed adaptation of the PointNet architecture, and evaluated the performance over several online sessions. We rigorously evaluated the DL-based decoders in a total of 28 human participants, and found that the DL-based models improved throughout the sessions as more training data became available and significantly outperformed a traditional BCI decoder by the last session. We also performed additional experiments to test an implementation of transfer learning by pretraining models on data from other subjects, and midsession training to reduce intersession variability. The results from these experiments showed that pretraining did not significantly improve performance, but updating the models’ midsession may have some benefit. Overall, these findings support the use of DL-based decoders for improving BCI performance in complex tasks like CP, which can expand the potential applications of BCI devices and help to improve the quality of lives of healthy and motor-impaired individuals.
Trends, safety, and efficacy of wearable male sexual devices
Authors: Loeb Charles A , Hammad Muhammad A M , Barham David W , Miller Jake , Young Kirsten , Horwitz Rainey , Amini Eliad , Nguyen Mai Xuan , Nag Nitish , Jenkins Lawrence C , Pearlman Amy M , Yafi Faysal A
Published: April 2024

Introduction

The prevalence of male sexual dysfunction (MSD) increases with age, with >50% of men aged >40 years reporting erectile dysfunction (ED). In recent years, wearable male sex devices (WMSDs) have been increasingly utilized by patients and recommended by sexual medicine clinicians.

Objectives

This study seeks to investigate the safety and efficacy of products currently marketed for the treatment of MSD.

Methods

Available products for WMSDs were reviewed by analyzing product websites, forums, advertisements, and clinical recommendations. Qualitative comparisons were based on patient reviews, cost, and specific features. Investigatory evidence and Food and Drug Administration status were also reviewed. Additionally, Google Trends was used to determine the popularity of devices over time.

Results

Eight WMSDs for the treatment of MSD and enhancement of sexual pleasure were reviewed. Constriction bands, such as the Maintain Ring Loop, Eddie by Giddy, and Xialla, have shown significant benefits in clinical trials and were the most popular devices among patients. Smart devices can provide real-time feedback on erectile quality and/or sexual performance. Similar to the RigiScan, the Adam sensor provides feedback on erectile quality while monitoring changes in penile tumescence during sleep with additional analysis available through a mobile application. Neuromodulation devices such as the Morari Patch and vPatch/in2 Patch use electrical stimulation to delay ejaculation and improve sexual function. The FirmTech Performance Ring uses sensors to track the vital signs of erectile fitness with clinical trials ongoing.

Conclusions

Overall, this review describes the available investigatory evidence for a range of WMSDs and highlights the potential benefits and limitations of these devices in treating MSD and enhancing sexual pleasure. Further research is needed to evaluate the effectiveness of these devices and to determine which ones may be the most suitable for individual patients.
Trusts and trust law in Thailand
Authors: Seela Andreas
Published: April 2024

Trusts in Thailand trace back to the late 19th century, influenced by the Bowring Treaty of 1855. Initially under English common law, the Thai Civil and Commercial Code of 1935 restricted the establishment of trusts. However, regulations evolved, with the Securities and Exchange Commission (SEC) proposing legislation in 2007 to facilitate trust transactions, particularly REITs and Infrastructure Trusts. Governed by Section 1686 of the Civil and Commercial Code and SEC regulations, REITs and Infrastructure Trusts cater to real estate and infrastructure investments. Despite past constraints, Thailand’s trust landscape now emphasizes regulatory frameworks for transparency, investor protection, and market competitiveness, potentially opening to private investors.
Forum: The Past, Present, and Futures of Modern British History
Authors: Linstrum Erik , Clarke Peter , Bingham Adrian , Black Lawrence , Langhamer Claire , Delap Lucy , Meyer Jessica , Ortolano Guy , Pedersen Susan , Bailkin Jordanna , Subramanian Divya
Published: April 2024

For the first issue of the renamed journal, Modern British History co-editor Erik Linstrum convened a group of scholars to reflect on the past, present, and possible futures of the field. The resulting contributions make no claim to provide a comprehensive or representative survey. Rather, they offer a variety of perspectives on where modern British history has been and where it might be going. Several contributions, written by former editors of Twentieth Century British History, drawn on the history of the journal as a way of thinking about the direction of the field and its subfields. Others consider the place of modern Britain in the wider discipline of history, grappling with questions of temporality and embodiment; the institutional and material contexts of scholarship; the role of national histories in a transnational world; and the response of historical writing to epidemiological, humanitarian, and ecological crisis. The sequence of contributions mirrors the evolution of the journal since its founding in 1990, beginning with political history and gradually encompassing a much broader range of subjects and methodologies as well as an expanded geographical ambit. Here are archive stories, pleas for new subjects, roadmaps for new approaches to old subjects, and attempts to identify master narratives. Taken together, these contributions demonstrate that modern British history has many houses—which is both a sign of intellectual vitality and a challenge for anyone wishing to generalize about the ‘state of the field’. If British modernity remains an abundant resource for ‘thinking with’, its contours and frontiers are tantalizingly up for grabs.
The Promise and Perils of Artificial Intelligence in Health Professions Education Practice and Scholarship
Authors: Patino Gustavo A. , Amiel Jonathan M. , Brown Megan , Lypson Monica L. , Chan Teresa M.
Published: April 2024

Artificial intelligence (AI) methods, especially machine learning and natural language processing, are increasingly affecting health professions education (HPE), including the medical school application and selection processes, assessment, and scholarship production. The rise of large language models over the past 18 months, such as ChatGPT, has raised questions about how best to incorporate these methods into HPE. The lack of training in AI among most HPE faculty and scholars poses an important challenge in facilitating such discussions. In this commentary, the authors provide a primer on the AI methods most often used in the practice and scholarship of HPE, discuss the most pressing challenges and opportunities these tools afford, and underscore that these methods should be understood as part of the larger set of statistical tools available.

Despite their ability to process huge amounts of data and their high performance completing some tasks, AI methods are only as good as the data on which they are trained. Of particular importance is that these models can perpetuate the biases that are present in those training datasets, and they can be applied in a biased manner by human users. A minimum set of expectations for the application of AI methods in HPE practice and scholarship is discussed in this commentary, including the interpretability of the models developed and the transparency needed into the use and characteristics of such methods.

The rise of AI methods is affecting multiple aspects of HPE including raising questions about how best to incorporate these models into HPE practice and scholarship. In this commentary, we provide a primer on the AI methods most often used in HPE and discuss the most pressing challenges and opportunities these tools afford.
Promotion in Place: A Model for Competency-Based, Time-Variable Graduate Medical Education
Authors: Goldhamer Mary Ellen J. , Pusic Martin V. , Nadel Eric S. , Co John Patrick T. , Weinstein Debra F.
Published: April 2024

Problem

Competency-based medical education is increasingly regarded as a preferred framework for physician training, but implementation is limited. U.S. residency programs remain largely time based, with variable assessments and limited opportunities for individualization. Gaps in graduates’ readiness for unsupervised care have been noted across specialties. Logistical barriers and regulatory requirements constrain movement toward competency-based, time-variable (CBTV) graduate medical education (GME), despite its theoretical benefits.

Approach

The authors describe a vision for CBTV-GME and an implementation model that can be applied across specialties. Termed “Promotion in Place” (PIP), the model relies on enhanced assessment, clear criteria for advancement, and flexibility to adjust individuals’ responsibilities and time in training based on demonstrated competence. PIP allows a resident’s graduation to be advanced or delayed accordingly. Residents deemed competent for early graduation can transition to attending physician status within their training institution and benefit from a period of “sheltered independence” until the standard graduation date. Residents who need extended time to achieve competency have graduation delayed to incorporate additional targeted education.

Outcomes

A proposal to pilot the PIP model of CBTV-GME received funding through the American Medical Association’s “Reimagining Residency” initiative in 2019. Ten of 46 residency programs in a multihospital system expressed interest and pursued initial planning. Seven programs withdrew for reasons including program director transitions, uncertainty about resident reactions, and the COVID-19 pandemic. Three programs petitioned their specialty boards for exemptions from time-based training. One program was granted the needed exemption and launched a PIP pilot, now in year 4, demonstrating the feasibility of implementing this model. Implementation tools and templates are described.

Next Steps

Larger-scale implementation with longer-term assessment is needed to evaluate the impact and generalizability of this CBTV-GME model.
Psoas Muscle Health is Correlated With Time to Achieve MCID in Patients With Predominant Axial Back Pain Following Decompression Surgery
Authors: Singh Nishtha , Zhao Eric R. , Johnson Mitchell A. , Singh Sumedha , Asada Tomoyuki , Shahi Pratyush , Maayan Omri , Araghi Kasra , Pajak Anthony , Subramanian Tejas , Simon Chad Z. , Korsun Maximilian K. , Tuma Olivia C. , Sheha Evan D. , Dowdell James E. , Qureshi Sheeraz A. , Iyer Sravisht
Published: April 2024

Study Design.

Retrospective cohort study.

Objective.

To determine the impact of psoas muscle health [cross-sectional area (CSA)] on achieving minimal clinically important differences (MCID) in patient-reported outcome measures (PROMs) following laminectomy for patients with predominant back pain (PBP) and leg pain (PLP).

Summary of Background Data.

Psoas muscle health is linked to postoperative outcomes in decompression patients, with MRI-based grading of psoas CSA correlating with these outcomes. However, evidence on its impact on symptomatic recovery, measured by PROMs, is lacking.

Methods.

One hundred six patients with PBP (VAS back > VAS leg) and 139 patients with PLP (VAS leg > VAS back) who underwent laminectomy from 2017 to 2021 were included. Axial T2 MRI images were analyzed for psoas CSA using a validated method. Based on the lowest-quartile normalized total psoas area (NTPA) thresholds, patients were divided into “good” and “poor” muscle health groups. The correlation analyses were performed between the psoas CSA and changes in PROMs. Kaplan–Meier survival analysis was conducted to determine the probability of achieving MCID as a function of time.

Results.

Of 106 patients with PBP, 83 (78.3%) had good muscle health, and 23 (21.6%) had poor muscle health. Of 139 patients with PLP, 54 (38.8%) had good muscle health, and 85 (61.1%) had poor muscle health. In the PBP group, older age was associated with poor muscle health (69.70±9.26 vs. 59.92±15.01, P=0.0002). For both cohorts, there were no differences in the rate of MCID achievement for any PROMs between the good and poor muscle health groups. In the PBP group, Kaplan–Meier analysis showed patients with good psoas health achieved MCID-VAS back and Oswestry Disability Index (ODI) in median times of 14 and 42 days (P=0.045 and 0.015), respectively.

Conclusion.

Good psoas muscle health is linked to faster attainment of MCID, especially in patients with PBP compared with PLP after decompression surgery.

Level of Evidence.

III.
Investigation of the relationship between coagulation parameters and mortality in COVID-19 infection
Authors: Ikiz Fatih , Ak Ahmet
Published: April 2024

This study, which included patients over the age of 18 who were diagnosed with coronavirus disease 2019 (COVID-19) in the emergency clinic, aims to determine the relationship between coagulation parameters and mortality. Epidemiologic data such as age, gender, medical history, vital parameters at emergency department admission, clinical findings, coagulation parameters such as d-dimer, prothrombin time (PT), active partial thromboplastin time (aPTT), international normalized ration (INR), fibrinogen, and platelet were evaluated. Patients with positive computerized tomography (CT) findings and positive polymerase chain reaction (PCR) together were included in the study. It was revealed that d-dimer, fibrinogen, INR, and PT values were higher in the elderly group. It was shown that there was a significant relationship between hospitalization days (ward or intensive care unit) and d-dimer levels. It was observed that d-dimer, fibrinogen elevation was significantly associated with prognosis by increasing mortality, and that platelet and aPTT values were also associated with prognosis and were lower in the mortality group. On the other hand, in receiver operating characteristic (ROC) analysis, the sensitivity and specificity data were 80.3%/80.0% for d-dimer, 70.5%/72.2% for fibrinogen, 58.2%/59.4% for aPTT, and 59.7%/59.2% for platelet, respectively. The overall classification success was 88.6% and mortality prediction success was 37.7% in the regression model of some coagulation parameters (d-dimer, fibrinogen, aPTT, and platelet) which were effective on prognosis. In conclusion, it was determined that d-dimer, fibrinogen, aPTT, and platelet parameters were directly associated with mortality and when these coagulation parameters were used together with the clinical, vital, and demographic data of the patients, the success of mortality prediction increased significantly.
Transition to Medicare Does Not Contribute to Rise in Outpatient Visits for Nonmelanoma Skin Cancer, Actinic Keratosis, or Actinic Cheilitis in the US Population
Authors: Taylor Kathryn M. E. , Woodie Brad , Neltner Scott A. , Fleischer Alan B.
Published: April 2024

BACKGROUND

Outpatient visits for nonmelanoma skin cancer (NMSC) and actinic keratoses (AK) have risen steadily in the United States, notably among Medicare beneficiaries. Individuals may delay seeking care for minimally symptomatic conditions until they qualify for Medicare coverage, indicating potential delay of nonurgent screening interventions for uninsured or underinsured patients younger than 65 years.

OBJECTIVE

This study investigates whether an atypical increase in outpatient visits for NMSC, AK, or actinic cheilitis (AC) occurs at the age of Medicare transition by utilizing the National Ambulatory Care Survey from 1993 to 2019.

MATERIALS AND METHODS

The National Ambulatory Care Survey data were analyzed for patients aged within 5 years of 65 years. Diagnoses were identified using International Classification of Diseases codes. Linear regression and outlier detection were used to identify a relationship between Medicare eligibility and outpatient visits for NMSC and AK/AC.

RESULTS

Predicted visits for AK/AC and NMSC increased with age. However, there was no evidence of a disproportionate increase in outpatient visits for NMSC and AK/AC at the age of Medicare eligibility.

CONCLUSION

Outside evidence indicates health care utilization increases after Medicare transition. This study's data do not support a corresponding rise in outpatient visits for NMSC and AK/AC at the age of Medicare eligibility.
Antenatal Late Preterm Steroids: The Evolution of the ALPS Trial
Authors: GYAMFI-BANNERMAN CYNTHIA
Published: April 2024

The Antenatal Late Preterm Steroids (ALPS) trial was designed to address respiratory morbidity common in infants born late preterm. The study was published in April, 2016 and, shortly thereafter, changed clinical practice in obstetrics in the United States. The following chapter describes the ALPS trial study design in detail, including the background leading to the trial, the study outcomes, and the initial findings of the long-term follow-up study. The ALPS story would not be complete without Elizabeth Thom, PhD, who died before her time. Her brilliance largely contributed to the design of the ALPS trial.
“What Did You Say, ChatGPT?” The Use of AI in Black Women's HIV Self-Education: An Inductive Qualitative Data Analysis
Authors: Chandler Rasheeta D. , Warner Sheena , Aidoo-Frimpong Gloria , Wells Jessica
Published: April 2024

The emergence of widely accessible artificial intelligence (AI) chatbots such as ChatGPT presents unique opportunities and challenges in public health self-education. This study examined simulations with ChatGPT for its use in public education of sexual health of Black women, specifically in HIV prevention and/or HIV PrEP use. The research questions guiding the study are as follows: (a) does the information ChatGPT offers about HIV prevention and HIV PrEP differ based on stated race? and (b) how could this relatively new platform inform public health education of Black women educating themselves about sexual health behaviors, diagnoses, and treatments? In addressing these questions, this study also uncovered notable differences in ChatGPT's tone when responding to users based on race. This study described valuable insights that can inform health care professionals, educators, and policymakers, ultimately advancing the cause of sexual health equity for Black women and underscoring the paradigm-shifting potential of AI in the field of public health education.
Can 18F FDG PET/CT metabolic parameters be used to noninvasively differentiate between different histopathological subtypes and Fuhrman grades of renal cell cancer?
Authors: Jain Yash , Agrawal Archi , Joshi Amit , Menon Santosh , Prakash Gagan , Murthy Vedang , Purandare Nilendu , Shah Sneha , Puranik Ameya , Choudhury Sayak , Shukla Varun , Dev Indraja , Prabhash Kumar , Noronha Vanita , Rangarajan Venkatesh
Published: April 2024

Aim

To evaluate relationship between metabolic PET metabolic parameters and size of the primary tumor, various histopathological subtypes of renal cell carcinoma (RCC) and Fuhrman grade of the tumors.

Material and methods

Retrospective analysis of 93 biopsy-proven RCC patients who underwent pretreatment flourine 18 flourodeoxyglucose PET/computed tomography (18F FDG PET/CT) was performed. Quantitative PET parameters, size of the primary tumor, histopathological subtypes and Fuhrman grades of the tumor were extracted. We tried to assess if there was any significant difference in the metabolic patterns of various histopathological subtypes of RCCs, Fuhrman grade of the tumors and size of the primary tumor.

Results

A significant correlation was noted between the size of primary tumor and maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) (P < 0.01, P < 0.001 and P < 0.001, respectively). SUVmax values correlated significantly with the histopathological subtype (P < 0.001). Further sub-analyses was also done by segregating the patients into Low grade (Fuhrman grade 1 and 2) vs. High grade (Fuhrman grade 3 and 4). SUVmax, MTV and TLG were significantly different between high grade vs. low grade tumors. ROC analysis yielded cut off values for SUVmax, MTV and TLG to differentiate between high grade from low grade tumors.

Conclusion

FDG PET/CT with the use of metabolic PET parameters can differentiate between different histopathological subtypes of RCC. Incorporation of metabolic parameters into clinical practice can potentially noninvasively identify patients with low-grade vs. high-grade RCC.
De Novo Metastatic Prostate Cancer Presenting With Atypical Lower-Limb Skeletal Metastases Detected on 68Ga-PSMA PET/CT
Authors: Yip Alexander , Yap June
Published: April 2024

Metastatic prostate cancer to the appendicular skeleton is rare. We present an 86-year-old man with undiagnosed prostate cancer presenting with unilateral foot pain. CT and MRI demonstrated a sclerotic midfoot suggestive of an infiltrative process. In view of an elevated PSA, metastatic disease was suspected, and bone scan confirmed osteoblastically active pelvic and lower-limb skeletal lesions. Subsequent prostate biopsy confirmed prostate adenocarcinoma. Staging 68Ga-PSMA PET/CT demonstrated PSMA-avid intraprostatic malignancy with pelvic and right lower-limb skeletal metastases. This is an unusual case of de novo 68Ga-PSMA–avid metastatic prostate cancer with atypical lower-limb skeletal metastases presenting with foot pain.
Free TcO4 − in 99mTc-PSMA Scan
Authors: Sahafi Pegah , Aryana Kamran , Moghadam Soroush Zarehparvar , Sadri Kayvan , Askari Emran
Published: April 2024

In a recent 99mTc-HYNIC-PSMA study conducted at our department, we examined 2 patients with prostate cancer referred for initial staging on the same day. The whole-body scans revealed radiotracer uptake in the gastric mucosa and thyroid glands, alluding to high levels of free TcO4
− in the injected vial. The scans were repeated after confirming acceptable radiopharmaceutical purity of 97% (normal range, 95%–100%). Interestingly, 1 patient had liver metastases at presentation, which remained non–PSMA-avid after repeating the scan. We have reviewed this pitfall, which has been reported with many radiotracers, yet not reported with PSMA tracers.
Characterizing the Rhinoplasty Outcomes Most Important to Patients, Surgeons, and the General Population
Authors: Salehi Parsa P. , Shah Hemali P. , Torabi Sina J. , Heiser Alyssa , Salehi Pauniz , Peng Grace L. , Nassif Paul , Lee Yan H. , Azizzadeh Babak
Published: April 2024

Understanding rhinoplasty characteristics important to patients, physicians, and society is essential for evaluating outcomes and designing optimal treatment plans. The authors aimed to elucidate specific rhinoplasty-related outcomes that are most important to patients, surgeons, and the general population. A cross-sectional survey comprising 11 rhinoplasty-specific characteristics, was distributed to patients, facial plastic surgeons, and the general population. Adult patients presenting for rhinoplasty consideration or follow-up after undergoing rhinoplasty were recruited. Characteristics rankings were compared between the 3 respondent groups using Spearman’s rank correlation coefficient (ρ). Responses from 150 surgeons, 111 patients, and 102 lay individuals from the general population were included for analysis. When ranking rhinoplasty-specific characteristics in order of importance, patients and the general population ranked “ability to breathe through nose while awake” first and “overall appearance of nose” as second. Surgeons ranked “overall appearance of nose” first and “ability to breathe through nose while awake” second. There were strong correlations between patients’ and surgeons’ rankings (Spearman’s ρ=0.836, P=0.002), between patients’ and the general population’s rankings (Spearman’s ρ=0.773, P=0.007), and between surgeons’ and the general population’s rankings (Spearman’s ρ=0.782, P=0.006). Our results highlight a significant correlation between characteristics of the “ideal” nose as determined by patients, surgeons, and the general population.
Heat stress induces IL-1β and IL-18 overproduction via ROS-activated NLRP3 inflammasome: implication in neuroinflammation in mice with heat stroke
Authors: Du Guoqiang , Yang Zixi , Wen Yin , Li Xusheng , Zhong Wenhong , Li Zhuo , Zhang Shiying , Luo Ensi , Ding Hongguang , Li Weifeng
Published: April 2024

Heat stroke induced cerebral damage via neuroinflammation. This study aimed to approach whether heat stress would promote NOD-like receptor protein 3 (NLRP3) inflammasome via reactive oxygen species (ROS). The mice were randomly divided into the sham group, the heat stress group, and the heat stress + TEMPOL (ROS scavenger) group. And the NLRP3−/− mice were applied and divided into the NLRP3−/− + sham group and the NLRP3−/− + heat stress group. Furthermore, the BV2 cells were divided into four groups following the intervention measures: the heat stress + TEMPOL group, the heat stress + Z-VAD-FMK (caspase-1 inhibitor) group, the heat stress group, and the control group. ROS levels were examined. The expression levels of NLRP3, caspase-1, IL-1β, and IL-18 were detected by western blotting and double immunofluorescence. We found that heat stress attack induced excessive ROS in microglia and subsequently activated NLRP3 inflammasome in both mice and BV2 cells. When ROS scavenged, the expression level of NLRP3 was downregulated. Furthermore, with NLRP3 inflammasome activation, the expression levels of caspase-1, IL-1β, and IL-18 were increased. In NLRP3−/− mice, however, the caspase-1, IL-1β, and IL-18 were significantly declined. Further experiments showed that pretreatment of caspase-1 inhibitor decreased the expression levels of IL-1β and IL-18. These results suggest that heat stress attack caused neuroinflammation via excessive ROS activating the NLRP3 inflammasome in microglia cells.