bluuebunny/crossref_metadata_2025 huggingface dataset:
The Practical Origins of Ideas
Authors: Queloz Matthieu
Published: April 2021

Why did such highly abstract ideas as truth, knowledge, or justice become so important to us? What was the point of coming to think in these terms? In The Practical Origins of Ideas, Matthieu Queloz presents a philosophical method designed to answer such questions: the method of pragmatic genealogy. Pragmatic genealogies are partly fictional, partly historical narratives exploring what might have driven us to develop certain ideas in order to discover what these do for us. The book uncovers an under-appreciated tradition of pragmatic genealogy which cuts across the analytic–continental divide, running from the state-of-nature stories of David Hume and the early genealogies of Friedrich Nietzsche to recent work in analytic philosophy by Edward Craig, Bernard Williams, and Miranda Fricker. However, these genealogies combine fictionalizing and historicizing in ways that even philosophers sympathetic to the use of state-of-nature fictions or real history have found puzzling. To make sense of why both fictionalizing and historicizing are called for, the book offers a systematic account of pragmatic genealogies as dynamic models serving to reverse-engineer the points of ideas in relation not only to near-universal human needs, but also to socio-historically situated needs. This allows the method to offer us explanation without reduction and to help us understand what led our ideas to shed the traces of their practical origins. Far from being normatively inert, moreover, pragmatic genealogy can affect the space of reasons, guiding attempts to improve our conceptual repertoire by helping us determine whether and when our ideas are worth having.
A Political and Ameliorative State of Nature
Authors: Queloz Matthieu
Published: April 2021

This chapter turns to Miranda Fricker’s genealogy of the virtue of testimonial justice and argues that her politicized state of nature illustrates how reverse-engineering can feed into conceptual engineering. The chapter first examines how she de-idealizes her state-of-nature model just enough to bring social heterogeneity and politics into it, thereby raising the question of how far genealogical models should be de-idealized. Second, it is shown how Fricker’s use of pragmatic genealogy differs from that of the other genealogists in being primarily ameliorative rather than explanatory. While earlier genealogists reverse-engineered the points of practices we already have, Fricker’s genealogy functions as a corrective, indicating respects in which our practices have in fact developed in ways that fall short of satisfying the needs highlighted by her model. It is then argued that making ameliorative use of the method requires pairing genealogy with a theory of error.
General Rules and Institutions of Private Law
Authors: Oda Hiroshi
Published: April 2021

The Civil Code is a cornerstone of private law. The general part of the Code sets out general rules of civil law such as the doctrine of good faith and fair dealing. Japanese courts sometimes modify a contract by referring to this doctrine in order to achieve an optimal outcome. The part on juristic acts are applied to contracts. Thus, contracts—juristic acts—against public policy are null and void.
Corporate Law
Authors: Oda Hiroshi
Published: April 2021

Japanese company law originally came from Germany. After the Second World War, there was some influence of US corporate law. In the aftermath of the economic crisis in the 1990s, Americanisation of corporate law was promoted by the business community. In line with ‘deregulation of corporate law’, regulations were relaxed. The amendments culminated to the enactment of the Company Law in 2005, separated from the Commercial Code. This led to the confusion regarding permissible scope of defensible measures in M&A (mergers and acquisitions). A positive development in corporate law is the improvement of corporate governance which is symbolised by the introduction of the Corporate Governance Code and the increased transparency in the system.
The Financial Instruments and Exchange Law
Authors: Oda Hiroshi
Published: April 2021

Japan adopted the Securities and Exchange Law in 1948, modelled on US law. While the securities market rapidly developed at the time of high economic growth, the regulatory system lagged behind the growth of the market. In the aftermath of the ‘bubble economy’, improvement of the regulatory system was sought. Following the UK ‘Big Bang’, Japan launched its financial ‘Big Bang’ in 1996/1997. There was substantial deregulation in this area. The Securities and Exchange Law was replaced by the Financial Instruments and Exchange Law in 2006. Corporate disclosure system as well as the rules on TOB (takeover bids) have been improved.
On Englishness and Britishness
Authors: Henderson Ailsa
Published: April 2021

In Chapter 2 we ask who are the English and where might they be found? Using different survey measures, we show that, even if English identity has strengthened since the early 1990s, those who view themselves as strongly English remain deeply attached to Britishness. We also demonstrate that, with the partial exception of London, there is very little regional variation in terms of patterns of national identity. There are, however, socio-economic and demographic differences. Older people, Anglicans, those in social class DE, and those born in England are all more likely to feel strongly or exclusively English. By contrast, younger voters, ‘non-white British’, and those born outside England are more likely to identify themselves as British. The chapter then examines what people associate with England and Britain. The responses are similar, but English and British identifiers prioritize slightly different elements of England and Britain’s past and present.
The English on Britain in the World
Authors: Henderson Ailsa
Published: April 2021

In Chapter 4 we turn our attention to the other side of the English nationalist coin— namely, English views of Britain and its place in the world. We show how Euroscepticism and negative attitudes towards immigration are both prevalent among those who feel exclusively or predominantly English. We also show how this group feels a strong sense of kinship with (some) of the nations of the so-called Anglosphere. We argue that the latter is an aspect of the imperial legacy in contemporary British politics.
Introduction
Authors: Dean Andrew
Published: April 2021

This chapter both gives an account of the critical treatment of post-World War II metafiction and introduces the key terms that guide the book. The existing critical debates about postwar metafiction have tended to emphasize metafiction’s incorporation of critical and philosophical discourse, and have suggested that it either makes the novel newly responsible to political communities or disables literature from intervening into political situations. More recent criticism based on literary institutions has tended to overlook key questions of literary value. The terms the chapter develops to renew discussion about postwar metafiction are ‘self of writing’ and ‘public author as signature’. These terms are derived from a reading of Miguel de Cervantes’s Don Quixote and J. L. Borges’s ‘Borges and I’. The self of writing refers to the figure of the author that a writer may imagine exists independent of discourse. The public author as signature represents the public understandings of an author that emerge from biography and the author’s corpus itself.
Survival and Resistance in Evangelical America
Authors: Gribben Crawford
Published: April 2021

Over the last thirty years, conservative evangelicals have been moving to the Northwest of the United States in an effort to survive and resist the impact of secular modernity. Their activity coincides with the promotion by prominent survivalist authors of a program of migration to the “American Redoubt,” a region encompassing Idaho, Montana, eastern parts of Washington and Oregon, and Wyoming, as a location within which to endure hostile social change or natural disaster. These migration movements have independent origins, but they overlap in their influences and aspirations, working in tandem and sometimes in mutual dependence to offer a vision of the present in which Christian values must be defended, if necessary, by force, and a vision of the future in which American society will be rebuilt according to biblical law. Drawing on Calvinist theology, the social theory of Christian Reconstruction, and libertarian politics, these believers are projecting significant soft power, with their books being promoted by leading secular publishers and being listed as New York Times bestsellers. The strategy is gaining momentum, making an impact in local political and economic life, while being repackaged for a wider audience in publications by a broader coalition of conservative commentators and in American mass culture. These believers recognize that they have lost the culture war—but another kind of conflict is beginning. This book examines the origins, evolution, and cultural reach of the migration that might reveal the most about the future of American evangelicalism.
Media
Authors: Gribben Crawford
Published: April 2021

The community at the heart of the migration to the Pacific Northwest was formed around a coterie of writers, whose distinctive arguments had come to prominence in a self-published magazine of theology and cultural criticism, Credenda Agenda (est. 1988). Over the last thirty years, the status and influence of this group has grown to warrant their working with major publishers, such as Random House and HarperCollins, and prominent writing partners, such as the late Christopher Hitchens, while also producing video productions on Netflix and Amazon Prime. This publishing program has been central to the community’s growth, advertising their key ideas while inviting readers and viewers to participate in the society that they established. Surveying this media culture, this chapter describes a well-resourced and increasingly influential conservative cultural movement that is preparing for survival, resistance, and the possibility that, as materiel for “God’s emerging army,” pens may be mightier than swords.
‘Personal Health Surveillance’: The Use of mHealth in Healthcare Responsibilisation
Authors: Davies Ben
Published: April 2021

There is an ongoing increase in the use of mobile health (mHealth) technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us to overcome—fairness of burdens and reliance on self-reporting—I note that these problems would only really be solved by unacceptably comprehensive forms of personal health surveillance which applies to all of us at all times. A more plausible model is to use personal health surveillance as a last resort for patients who would otherwise independently qualify for responsibility-based penalties. However, I note that there are still a number of ethical and practical problems that such a policy would need to overcome. The prospects of mHealth enabling a fair, genuinely cost-saving policy of patient responsibility are slim.
Seasonal and day–night changes in the vertical distribution of Gnathophausia longispina and G. elegans (Peracarida, Lophogastrida) in the East China Sea
Authors: Nishiuchi Koh , Sassa Chiyuki , Kitajima Satoshi , Kiyomoto Yoko , Hasegawa Toru , Yamada Haruya , Taneda Takeshi , Sakai Takeshi , Takahashi Motomitsu , Tsukamoto Yohichi
Published: April 2021

Seasonal and day–night changes in the vertical distribution and habitat of mesopelagic crustaceans, Gnathophausia longispina and G. elegans were investigated in the East China Sea during four oceanographic cruises carried out between May 2012 and January 2013. The abundance of G. elegans was approximately one-tenth that of G. longispina, although both species appeared throughout the year. The main distribution range of G. longispina was 100–600 m, and G. elegans was 600–700 m. Only G. longispina showed ontogenetic differences in diel vertical migration (ODVM); most individuals inhabited depths of 500–600 m during the day and 100–400 m at night when younger individuals inhabited shallower layers than mature individuals. Overall, both species showed a small overlap in their vertical distribution at around 600-m depth. Vertical segregation of habitat could have facilitated the sympatric biogeographic distribution of these two congeneric species around the West/Central Pacific Ocean.
Endosperm-based incompatibilities in hybrid monkeyflowers
Authors: Kinser Taliesin J. , Smith Ronald D. , Lawrence Amelia H. , Cooley Arielle M. , Vallejo-Marín Mario , Conradi Smith Gregory D. , Puzey Joshua R.
Published: April 2021

Endosperm is an angiosperm innovation central to their reproduction whose development, and thus seed viability, is controlled by genomic imprinting, where expression from certain genes is parent-specific. Unsuccessful imprinting has been linked to failed inter-specific and inter-ploidy hybridization. Despite their importance in plant speciation, the underlying mechanisms behind these endosperm-based barriers remain poorly understood. Here, we describe one such barrier between diploid Mimulus guttatus and tetraploid Mimulus luteus. The two parents differ in endosperm DNA methylation, expression dynamics, and imprinted genes. Hybrid seeds suffer from underdeveloped endosperm, reducing viability, or arrested endosperm and seed abortion when M. guttatus or M. luteus is seed parent, respectively, and transgressive methylation and expression patterns emerge. The two inherited M. luteus subgenomes, genetically distinct but epigenetically similar, are expressionally dominant over the M. guttatus genome in hybrid embryos and especially their endosperm, where paternal imprints are perturbed. In aborted seeds, de novo methylation is inhibited, potentially owing to incompatible paternal instructions of imbalanced dosage from M. guttatus imprints. We suggest that diverged epigenetic/regulatory landscapes between parental genomes induce epigenetic repatterning and global shifts in expression, which, in endosperm, may uniquely facilitate incompatible interactions between divergent imprinting schemes, potentially driving rapid barriers.
Policewomen’s Experiences of Working during Lockdown: Results of a Survey with Officers from England and Wales
Authors: Fleming Jenny , Brown Jennifer
Published: April 2021

Policing is a high-stress occupation requiring emotional management when facing job-related violence, threats to safety and well-being, work-life disruption, and unpredictable hours. A national health pandemic coupled with public order and restraint imperatives has compounded the levels of stress in policing. In the UK, new working patterns have been negotiated to manage the constraints of a different working environment during COVID-19. Using a self-administered survey, this article explores the experiences of 473 female police officers working during the first lockdown in 2020. The article shows that the COVID-19 preventative measures forced police services to navigate new and varied working patterns for their employees. Previous resistance to flexible working practices in policing was put aside as police services sought to manage the virus in its own ranks as well as policing the public. Preliminary findings suggest that officers working from home were more likely to feel satisfied with management responses compared with those working on the front line, although negative attitudes from colleagues and management towards those working from home were present. Those not working from home reported higher levels of stress related to their Force’s lack of communication with them about their welfare.
Federalism, Polarization, and Policy Responsibility during COVID-19: Experimental and Observational Evidence from the United States
Authors: Jacobs Nicholas
Published: April 2021

This article considers the ways in which partisanship structured public attitudes about the United States’ multiple governments as each tried to mitigate the spread of COVID-19 during the spring and summer of 2020. The evidence shows that Democrats and Republicans both made distinctions among their local, state, and federal governments, assigning them different functional responsibilities. Yet, members of the two parties did not agree on that division of intergovernmental responsibility. Rather, across a variety of issues, polarized partisan identities structured beliefs about the operation and efficacy of the American federal system’s ability to contend with the spread of coronavirus. Moreover, these beliefs did not stem from prior ideological commitments or the different composition of Democratic or Republican communities. Instead, party leaders proved especially capable of shifting public attitudes on questions of federal versus state authority through their shifting rhetoric and strategic framing.
Selection, Leverage, and Default in the Mortgage Market
Authors: Gupta Arpit , Hansman Christopher
Published: April 2021

We ask whether the correlation between mortgage leverage and default is due to moral hazard (the causal effect of leverage) or adverse selection (ex ante risky borrowers choosing larger loans). We separate these information asymmetries using a natural experiment resulting from the contract structure of option adjustable-rate mortgages and unexpected 2008 divergence of indexes that determine rate adjustments. Our point estimates suggest that moral hazard is responsible for 40$\%$ of the correlation in our sample, while adverse selection explains 60$\%$. We calibrate a simple model to show that leverage regulation must weigh default prevention against distortions due to adverse selection.
Root joint involvement in spondyloarthritis: a post hoc analysis from the international ASAS-PerSpA study
Authors: Ziadé Nelly , El Hajj Jean , Rassi Joe , Hlais Sani , López-Medina Clementina , Gamal Sherif M , Elzorkany Bassel , Dougados Maxime , Baraliakos Xenofon
Published: April 2021

Objectives

The primary objective was to compare the clinical characteristics of SpA patients with and without root joint disease (RJD+ and RJD–). The secondary objectives were to compare the prevalence of RJD across various SpA subtypes and in different world regions, and to compare the SpA axial severity and SpA burden between RJD+ and RJD–.

Methods

This is a post hoc analysis of the Assessment of Spondyloarthritis International Society PerSpA study (PERipheral involvement in SpondyloArthritis), which included 4465 patients with SpA [axial (axSpA), peripheral (pSpA), PsA, IBD, reactive and juvenile] according to the rheumatologist’s diagnosis. RJD was defined as the ‘ever’ presence of hip or shoulder involvement related to SpA, according to the rheumatologist. Patient characteristics were compared between RJD+ and RJD–. Multivariable stepwise binary logistic regression analyses were conducted to identify factors associated with ‘RJD’, ‘hip’ and ‘shoulder’ involvement.

Results

RJD was significantly associated with the SpA main diagnosis (highest in pSpA), a higher prevalence of HLA-B27 positivity, enthesitis, tender and swollen joints, CRP, conventional synthetic DMARDs, loss of lumbar lordosis and occiput-wall distance >0. RJD was more prevalent in Asia, and occurred in 1503 patients (33.7%), with more hip (24.2%) than shoulder (13.2%) involvement. Hip involvement had a distinct phenotype, similar to axSpA (including younger age at onset, HLA-B27 positivity), whereas shoulder involvement was associated with features of pSpA (including older age at onset).

Conclusion

RJD+ SpA patients had a distinctive clinical phenotype compared with RJD–. Hip involvement, based on the rheumatologist’s diagnosis, was more prevalent than shoulder involvement and was clinically distinct.
Risk Factors, Incidence, and Outcomes of Neuroleptic Malignant Syndrome on Long-Acting Injectable vs Oral Antipsychotics in a Nationwide Schizophrenia Cohort
Authors: Guinart Daniel , Taipale Heidi , Rubio Jose M , Tanskanen Antti , Correll Christoph U , Tiihonen Jari , Kane John M
Published: April 2021

Introduction

Long-acting injectable antipsychotics (LAIs) are associated with multiple positive outcomes in psychosis, but it is unclear whether LAIs are associated with worse outcomes if neuroleptic malignant syndrome (NMS), a potentially lethal adverse effect, occurs.

Methods

We used nationwide and nationally representative databases of healthcare encounters in Finland to study the incidence and outcome predictors of NMS in patients diagnosed with schizophrenia/schizoaffective disorder between January 01, 1972 and December 31, 2017. Using a nested case-control design, we also explored differences by antipsychotic formulation (LAI vs oral antipsychotic [OAP]) and class (first-generation antipsychotic [FGA] vs second-generation antipsychotic [SGA]).

Results

One hundred seventy-two NMS cases and 1441 sex-, age-, and diagnosis-matched controls were included (age = 58.8 ± 13.1 years, males = 59.9%). Incidence of NMS was 1.99 (1.98–2.00) per 10 000 person-years. The likelihood of developing NMS did not differ by antipsychotic formulation (adjusted odds ratio [aOR]: 0.89, 95% confidence intervals [95% CI]: 0.59–1.33, for LAIs vs OAPs) or class (FGA-OAP vs SGA-OAP [aOR: 1.08, 95% CI: 0.66–1.76], FGA-LAI [aOR: 0.89, 95% CI: 0.52–1.53], SGA-LAI [aOR: 1.35, 95% CI: 0.58–3.12]). NMS risk factors included antipsychotic treatment change: increased number (odds ratios [OR]: 5.00, 95% CI: 2.56–9.73); decreased number/switch (OR: 2.43, 95% CI: 1.19–4.96); higher antipsychotic dose (>2DDDs–OR: 3.15, 95% CI: 1.61–6.18); co-treatment with anticholinergics (OR: 2.26, 95% CI: 1.57–3.24), lithium (OR: 2.16, 95% CI: 1.30–3.58), benzodiazepines (OR: 2.02, 95% CI: 1.44–3.58); and comorbid cardiovascular disease (OR: 1.73, 95% CI: 1.22–2.45). Within 30 days, 4.7% of cases with NMS died (15.1% within 1 year) without differences by antipsychotic formulation. NMS reoccurred in 5 of 119 subjects (4.2%), after a median = 795 (range = 77–839) days after rechallenge with antipsychotics.

Conclusion

NMS remains a potentially life-threatening risk, yet these results should further contribute to mitigate concerns about LAI safety regarding NMS onset or outcomes, including mortality.
Longitudinal associations of sleep problems with alcohol and cannabis use from adolescence to emerging adulthood
Authors: Troxel Wendy M , Rodriguez Anthony , Seelam Rachana , Tucker Joan S , Shih Regina A , Dong Lu , D’Amico Elizabeth J
Published: April 2021

Study Objectives

This study examined longitudinal associations of sleep problems with alcohol and cannabis use across six annual waves of data from adolescence to emerging adulthood.

Methods

Participants were 3,265 youth from California (ages 16–22 across waves). At each wave, past-month alcohol use and cannabis use, mental health, and several dimensions of sleep health (i.e. social jetlag, bedtimes, time in bed, trouble sleeping) were assessed via questionnaire. Parallel process latent growth models examined the association between sleep and alcohol or cannabis use trajectories and the role of mental health in contributing to such trajectories.

Results

Smaller declines in social jetlag (r = 0.11, p = 0.04), increases in trouble sleeping (r = 0.18, p < 0.01), and later weekday (r = 0.16, p < 0.01) and weekend bedtimes (r = 0.25, p < 0.01) were associated with increases in likelihood of alcohol use over time. Declines in weekend TIB (r = −0.13, p = 0.03), as well as increases in weekday TIB (r = 0.11, p = 0.04) and later weekday (r = 0.18, p < 0.01) and weekend bedtime (r = 0.24, p < 0.01), were associated with increases in likelihood of cannabis use over time. Most associations remained significant after controlling for time-varying mental health symptoms.

Conclusions

Trajectories of sleep health were associated with trajectories of alcohol and cannabis use during late adolescence to emerging adulthood. Improving sleep is an important target for intervention efforts to reduce the risk of substance use during this critical developmental transition.
The Micro-politics of Recognition and Care: How Adult Children in Urban China Negotiate Relationships with Emigrant Siblings
Authors: Sun Ken Chih-Yan , Kibria Nazli
Published: April 2021

This article offers the concept of “economies of recognition” to analyze the moral frames that siblings caring for left-behind parents in China use to negotiate intimate connections to their emigrant brothers and sisters. We argue that the impact of family dislocation on sibling relations is shaped by family members’ co-constructed relational infrastructure. Our findings identify four types of relational infrastructure—collaboration, intrusion/interference, voluntary takeover, and feeling left behind—that mediate the impact of geographic proximity on parental caregiving. We suggest that the interplay between physical distance and elder care is emotionally experienced, interactionally evaluated, and symbolically understood. Understanding solidarity, conflicts, and ambivalence in the contexts of family crisis requires a close examination of how members of a care network attribute each other’s roles and contributions to power symmetry or asymmetry. This explains why the advice, information, money, people, and emotions that are circulated are thought of as helpful resources in some cases but perceived as constraints in others.
Democracy and Demography: Intersectional Dimensions of German Politics
Authors: Ferree Myra Marx
Published: April 2021

Feminist theory revealed liberal democracy as gendered masculine in a macrointersectional way that privileged racial-ethnic and economic power, enforced heteronormativity, and constructed gender-binary citizenship. Merely reformed to accommodate women, many brotherhood–breadwinner democracies now face deeper challenges. As the second demographic transition undermines the hegemony of binary gender relations, it reorganizes political conflict on an axis of reproductive politics. Germany’s Green and Alternative für Deutschland parties exemplify opposite ends of this axis. The Green clusters of issues reflect intersectional societal ideals that demasculinize democracy, while reactionary populism repoliticizes masculinity to defend the family–state relations of the breadwinner–brotherhood gender system.
Tree species rather than type of mycorrhizal association drive inorganic and organic nitrogen acquisition in tree–tree interactions
Authors: Reuter Robert , Ferlian Olga , Tarkka Mika , Eisenhauer Nico , Pritsch Karin , Simon Judy
Published: April 2021

Mycorrhizal fungi play an important role for the nitrogen (N) supply of trees. The influence of different mycorrhizal types on N acquisition in tree–tree interactions is, however, not well understood, particularly with regard to the competition for growth-limiting N. We studied the effect of competition between temperate forest tree species on their inorganic and organic N acquisition in relation to their mycorrhizal type (i.e., arbuscular mycorrhiza or ectomycorrhiza). In a field experiment, we quantified net N uptake capacity from inorganic and organic N sources using 15N/13C stable isotopes for arbuscular mycorrhizal tree species (i.e., Acer pseudoplatanus L., Fraxinus excelsior L., and Prunus avium L.) as well as ectomycorrhizal tree species (i.e., Carpinus betulus L., Fagus sylvatica L., and Tilia platyphyllos Scop.). All species were grown in intra- and interspecific competition (i.e., monoculture or mixture). Our results showed that N sources were not used complementarily depending on a species’ mycorrhizal association, but their uptake rather depended on the competitor, indicating species-specific effects. Generally, ammonium was preferred over glutamine and glutamine over nitrate. In conclusion, our findings suggest that the inorganic and organic N acquisition of the studied temperate tree species is less regulated by mycorrhizal association but rather by the availability of specific N sources in the soil as well as the competitive environment of different tree species.
Alternation between taxonomically divergent hosts is not the major determinant of flavivirus evolution
Authors: Pontremoli Chiara , Forni Diego , Clerici Mario , Cagliani Rachele , Sironi Manuela
Published: April 2021

Flaviviruses display diverse epidemiological and ecological features. Tick-borne and mosquito-borne flaviviruses (TBFV and MBFV, respectively) are important human pathogens that alternate replication in invertebrate vectors and vertebrate hosts. The Flavivirus genus also includes insect-specific viruses (ISFVs) and viruses with unknown invertebrate hosts. It is generally accepted that viruses that alternate between taxonomically different hosts evolve slowly and that the evolution of MBFVs and TBFVs is dominated by strong constraints, with limited episodes of positive selection. We exploited the availability of flavivirus genomes to test these hypotheses and to compare their rates and patterns of evolution. We estimated the substitution rates of CFAV and CxFV (two ISFVs) and, by taking into account the time-frame of measurement, compared them with those of other flaviviruses. Results indicated that CFAV and CxFV display relatively different substitution rates. However, these data, together with estimates for single-host members of the Flaviviridae family, indicated that MBFVs do not display relatively slower evolution. Conversely, TBFVs displayed some of lowest substitution rates among flaviviruses. Analysis of selective patterns over longer evolutionary time-frames confirmed that MBFVs evolve under strong purifying selection. Interestingly, TBFVs and ISFVs did not show extremely different levels of constraint, although TBFVs alternate among hosts, whereas ISFVs do not. Additional results showed that episodic positive selection drove the evolution of MBFVs, despite their high constraint. Positive selection was also detected on two branches of the TBFVs phylogeny that define the seabird clade. Thus, positive selection was much more common during the evolution of arthropod-borne flaviviruses than previously thought. Overall, our data indicate that flavivirus evolutionary patterns are complex and most likely determined by multiple factors, not limited to the alternation between taxonomically divergent hosts. The frequency of both positive and purifying selection, especially in MBFVs, suggests that a minority of sites in the viral polyprotein experience weak constraint and can evolve to generate new viral phenotypes and possibly promote adaptation to new hosts.
The Spillover Impact of Index Insurance on Agricultural Investment by Cotton Farmers in Burkina Faso
Authors: Stoeffler Quentin , Carter Michael , Guirkinger Catherine , Gelade Wouter
Published: April 2021

This paper examines whether agricultural insurance can boost investment by small scale farmers in West Africa. It is based on a randomized evaluation designed to analyze the impacts of index insurance for cotton farmers in Burkina Faso. No impact of insurance was found on cotton, but, consistent with microeconomic theory, significant spillover impacts on investment in other agricultural activities were measured. Furthermore, the effects of insurance payouts on farmers hit by a shock confirm the potential of index insurance as a risk-management tool. However, this research uncovers important flaws in the implementation of the project that limited its impact on cotton. Overall, this study suggests a promising role for index insurance in stimulating investment, but also draws attention to key challenges to the efficient delivery of insurance to small farmers. Finally, the study’s hybrid, mixed methods RCT offers lessons for the evaluation of complex interventions where trust, understanding, and timing are all important.
Diagnostic delay in axial spondyloarthritis – a past or current problem?
Authors: Poddubnyy Denis , Sieper Joachim
Published: April 2021

Purpose of review

To evaluate recent data on diagnostic delay in axial spondyloarthritis (axSpA), factors affecting the delay, potential ways of early diagnosis improvement, and risks associated with early diagnostic approaches.

Recent findings

Although axSpA can be diagnosed nowadays within the first months after symptom onset, the diagnostic delay remains with several years still remarkably high in many parts of the world. Female gender, human leukocyte antigen-B27 negativity, and younger age at disease onset are among factors associated with a delayed referral to a rheumatologist and consequently with a larger diagnostic delay. Early referral algorithms are helpful in the identification of patients with a high probability of axSpA among patients with chronic back pain. A careful diagnostic evaluation with correct imaging interpretation is required to avoid misdiagnosis of axSpA in patients with unspecific back pain.

The diagnostic delay is still considerable in axSpA. The ways to early diagnosis in axSpA are well defined. Imaging findings should always be considered in the clinical context to avoid axSpA misdiagnosis.
Clusters of Double Triggering Impact Clinical Outcomes: Insights From the EPIdemiology of Patient-Ventilator aSYNChrony (EPISYNC) Cohort Study
Authors: Sousa Mayson Laérciod e Araújo , Magrans Rudys , Hayashi Fátima K. , Blanch Lluís , Kacmarek Robert M. , Ferreira Juliana C.
Published: April 2021

OBJECTIVES:

To measure the impact of clusters of double triggering on clinical outcomes.

DESIGN:

Prospective cohort study.

SETTING:

Respiratory ICU in Brazil.

PATIENTS:

Adult patients under recent mechanical ventilation and with expectation of mechanical ventilation for more than 24 hours after enrollment.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We used a dedicated software to analyze ventilator waveforms throughout the entire period of mechanical ventilation and detect double triggering. We defined a cluster of double triggering as a period of time containing at least six double triggering events in a 3-minute period. Patients were followed until hospital discharge. We addressed the association between the presence and the duration of clusters with clinical outcomes. A total of 103 patients were enrolled in the study and 90 (87%) had at least one cluster of double triggering. The median number of clusters per patient was 19 (interquartile range, 6–41), with a median duration of 8 minutes (6–12 min). Compared with patients who had no clusters, patients with at least one cluster had longer duration of mechanical ventilation (7 d [4–11 d] vs 2 d [2–3 d]) and ICU length of stay (9 d [7–16 d] vs 13 d [2–8 d]). Thirty-three patients had high cumulative duration of clusters of double triggering (≥ 12 hr), and it was associated with longer duration of mechanical ventilation, fewer ventilator-free days, and longer ICU length of stay. Adjusted by duration of mechanical ventilation and severity of illness, high cumulative duration of clusters was associated with shorter survival at 28 days (hazard ratio, 2.09 d; 95% CI, 1.04–4.19 d).

CONCLUSIONS:

Clusters of double triggering are common and were associated with worse clinical outcomes. Patients who had a high cumulative duration of clusters had fewer ventilator-free days, longer duration of mechanical ventilation, longer ICU length of stay, and shorter survival than patients with low cumulative duration of cluster.
Background, Etiology, and Subtypes of Urinary Incontinence
Authors: DIETER ALEXIS A.
Published: April 2021

Urinary incontinence (UI) is the involuntary loss of urine. UI is a prevalent condition that affects people of all ages, becoming more common with older age, and which negatively affects the lives of millions of people. Although the pathophysiology behind UI is still being researched, we review here the basic neuromuscular system regulating urinary control and several other potential factors influencing the lower urinary tract dysfunction that contributes to UI including the urobiome and genetic variants. The specific subtypes, risk factors and findings associated with UI are reviewed.
The Effect of Ultra-slow Velocities on Insertion Forces: A Study Using a Highly Flexible Straight Electrode Array
Authors: Zuniga M. Geraldine , Hügl Silke , Engst Benjamin G. , Lenarz Thomas , Rau Thomas S.
Published: April 2021

Objective:

The present study sought to 1) characterize insertion forces resulting from a flexible straight electrode array (EA) inserted at slow and ultra-slow insertion velocities, and 2) evaluate if ultra-slow velocities decrease insertion forces independent of other variables.

Background:

Low insertion forces are desirable in cochlear implant (CI) surgery to reduce trauma and preserve hearing. Recently, ultra-slow insertion velocities (lower than manually feasible) have been shown to produce significantly lower insertion forces using other EAs.

Methods:

Five flexible straight EAs were used to record insertion forces into an inelastic artificial scala tympani model. Eleven trial recordings were performed for each EA at five predetermined automated, continuous insertion velocities ranging from 0.03 to 1.6 mm/s.

Results:

An ultra-slow insertion velocity of 0.03 mm/s resulted in a median insertion force of 0.010 N at 20 mm of insertion depth, and 0.026 N at 24.3 mm—the final insertion depth. These forces represent only 24 to 29% of those measured using 1.6 mm/s. After controlling for insertion depth of the EA into the artificial scala tympani model and trial insertion number, decreasing the insertion velocity from 0.4 to 0.03 mm/s resulted in a 50% decrease in the insertion forces.

Conclusion:

Using the tested EA ultra-slow velocities can decrease insertion forces, independent of variables like insertion depth. Our results suggest ultra-slow velocities can reduce insertion forces at least 60%, compared with humanly feasible continuous velocities (≥0.9 mm/s).
Histopathologic Diagnosis Discrepancies Between Preoperative Endoscopic Forceps Biopsies and Specimens Resected by Endoscopic Submucosal Dissection in Superficial Gastric Neoplasms
Authors: Aliaga Ramos Josué , Pedrosa Moises S. , Yoshida Naohisa , Abdul Rani Rafiz , Arantes Vitor N.
Published: April 2021

Background:

The standard of practice when a superficial lesion was identified during upper GI endoscopy is to take an endoscopic forceps biopsy (EFB) of the lesion. The histopathologic findings then will determine the management plan. Endoscopic submucosal dissection (ESD) enables en-bloc resection for early neoplasms of the gastrointestinal tract and provides an adequate specimen that permits a more reliable histopathologic assessment. The objective of this study was to determine the rate of histopathologic discrepancy between EFB and specimens resected by ESD, and to identify the predisposing risk factors for this discordance.

Materials and Methods:

This is a retrospective study, enrolling patients with superficial gastric neoplasms that underwent EFB followed by ESD. We divided cases to concordant or discordant group according to the histopathologic diagnosis of EFB and ESD specimens. We also analyzed the features that may have influenced the occurrence of histopathologic discordance and the association between discordant samples of adenocarcinoma and neoplastic invasion to deeper layers.

Results:

A total of 115 gastric ESD procedures were performed with 84 patients meeting the inclusion criteria. Histopathologic discordance between EFB and ESD specimens were observed in 35.8% of cases (30/84 lesions). The univariant-bivariant analysis and multivariate logistic regression analysis showed that histologic discordance was closely related to the size of the lesions (P=0.028).

Conclusion:

Histopathologic discrepancy between EFB and ESD specimens may occur in approximately one-third of cases, particularly for lesions over 20 mm, which may lead to crucial delays in gastric cancer precise diagnosis and treatment.
Characterizing a cohort of Egyptian patients with acute-on-chronic liver failure
Authors: El Ray Ahmed , Fouad Rabab , ElMakhzangy Hesham , El Beshlawy Mohammed , Moreau Richard , Sherbiny Mahmoud
Published: April 2021

Background and Aim

Several studies performed in Western countries and Asia have shown that acute-on-chronic liver failure (ACLF) is an acute decompensation of cirrhosis characterized by organ system failures and high short-term mortality. However, the characteristics of Egyptian patients with ACLF have not yet been described. The aim of this study was to assess Egyptian patients with cirrhosis hospitalized for an acute decompensation using criteria and scores developed by the EASL-CLIF Consortium.

Patients and methods

One hundred and twenty patients with acutely decompensated cirrhosis nonelectively admitted to two tertiary hospitals were prospectively included. Ninety-three percent of patients had hepatitis C virus-related liver disease.

Results

Of the 120 patients, 40 had ACLF; of these 45% had ACLF-1, 33% ACLF-2, and the remaining 22% had ACLF-3. None of the patients with ACLF had received direct-antiviral agents (DAAs) while 30% of patients without ACLF were treated with these agents. The prevalence of prior episodes of decompensation was significantly higher in patients with ACLF (60% vs. 28%). The prevalence of precipitating events such as bacterial infection alone or combined with gastrointestinal hemorrhage was higher in patients with ACLF than in those without. Systemic inflammation, assessed with white blood-cell count and plasma C reactive levels, was more intense in ACLF.

Conclusion

Among Egyptian patients with acutely decompensated cirrhosis nonelectively admitted to the hospital, those with ACLF were distinct from those without ACLF, not only by the presence of organ failures, but also the absence DAA therapy, more frequent prior episodes of decompensation, more frequent bacterial infections as a precipitant, and more intense systemic inflammation.
A narrative review of frailty assessment in older patients at the emergency department
Authors: van Dam Carmen S. , Hoogendijk Emiel O. , Mooijaart Simon P. , Smulders Yvo M. , de Vet Riekie C.W. , Lucke Jacinta A. , Blomaard Laura C. , Otten René H.J. , Muller Majon , Nanayakkara Prabath W.B. , Trappenburg Marijke C. , Peters Mike J.L.
Published: April 2021

Optimizing emergency care for the aging population is an important future challenge, as the proportion of older patients at the emergency department (ED) rapidly increases. Older patients, particularly those who are frail, have a high risk of adverse outcomes after an ED visit, such as functional decline, institutionalization, and death. The ED can have a key position in identifying frail older patients who benefit most from comprehensive geriatric care [including delirium preventive measures, early evaluation of after-discharge care, and a comprehensive geriatric assessment (CGA)]. However, performing extensive frailty assessment is not suitable at the ED. Therefore, quick and easy-to-use instruments are needed to identify older patients at risk for adverse outcomes. This narrative review outlines the importance and complexity of frailty assessment at the ED. It aligns the available screening instruments, including clinical judgment as frailty assessment, and summarizes arguments for and against frailty assessment at the ED.
Granulocyte Colony-Stimulating Factor Administration at 1 Hour Before 18F-FDG PET Does Not Increase Bone Marrow FDG Accumulation
Authors: Kawabata Kazuna , Hosono Makoto , Tanaka Hiroki , Hyuga Mizuki , Kanagaki Mitsunori
Published: April 2021

A 74-year-old man with diffuse large B-cell lymphoma underwent 18F-FDG PET/CT to evaluate the response to chemotherapy. Although granulocyte colony-stimulating factor was incidentally administered 1 hour before FDG administration, bone marrow FDG accumulation did not increase compared with the previous 18F-FDG PET/CT examination without granulocyte colony-stimulating factor administration. The mean SUVmax of 12 thoracic and 5 lumbar vertebrae was 2.55 (range, 2.14–3.36) and 3.19 (range, 2.49–4.28) in the present and previous examinations, respectively.
Utility of 18F–Prostate-Specific Membrane Antigen 1007 in Imaging of Tumor Thrombus of Renal Cell Carcinoma
Authors: Zeng Yuping , Luo Jiandong , Liao Hengbin , Chen Ping
Published: April 2021

A 64-year-old man was referred for 18F–prostate-specific membrane antigen 1007 PET/CT with a suspicion of recurrence and metastases of renal cell carcinoma after the resection of right renal cell carcinoma. The scan showed intense tracer concentration in the inferior vena cava and the right atrium, which was later proven on histopathologic examination as tumor thrombus of renal cell carcinoma. Adding on to previous studies with 18F–prostate-specific membrane antigen 1007 in the primary renal tumor, the case proved that the tumor thrombus of renal cell carcinoma could also show intense tracer concentration and further highlights its utility in renal cell carcinoma.
Noninvasive Detection of Cardiac Amyloid With 11C-Pittsburgh Compound B PET/CT and 99mTc-PYP Scintigraphy
Authors: Wang Xuezhu , Wang Yining , Li Jian , Huo Li , Zhang Shuyang
Published: April 2021

We report the imaging findings of 2 cases of cardiac amyloidosis, one light chain (AL) type and another transthyretin (ATTR) type. The images showed 11C-Pittsburgh compound B (11C-PIB) uptake in the heart with AL amyloidosis, whereas the ATTR amyloidosis showed 11C-PIB–negative and 99mTc-PYP–positive uptake in the heart. It demonstrated that using 99mTc-PYP scintigraphy and 11C-PIB PET/CT might be able to differentiate these 2 major types of cardiac amyloidosis noninvasively.
Striatibotrys neoeucylindrosporus sp. nov., a Stachybotrys-like fungus from North America
Authors: Schultes Neil P. , Castañeda-Ruiz Rafael F. , Marra Robert E. , Strzalkowski Noelle , De-Wei Li
Published: April 2021

Two isolates from Canada and the USA (UAMH 7122 and UAMH 7211, respectively) previously identified as Stachybotrys eucylindrosporus were studied by morphology and six-locus phylogeny (cmdA, ITS, LSU, rpb2, tef1α and tub2). UAMH 7122 and UAMH 7211 are morphologically related but phylogenetically distinct from Striatibotrys eucylindrosporus (≡Stachybotrys eucylindrosporus) and Str. rhabdosporus. Hence, UAMH 7122 and UAMH 7211 are described as a new species, Striatibotrys neoeucylindrosporus sp. nov. with UAMH 7211 as the holotype. The characters of this species include some phialides proliferating by holoblastic extension of phialides and conidia clavate, subcylindrical or cylindrical ellipsoid, or dumbbell-shaped, dark brown to olivaceous grey when mature, longitudinally striate, 10.3–12.3×3–3.8 µm. A key to the species of Striatibotrys is provided.