bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic review of pregnancy and renal outcomes for women with chronic kidney disease receiving assisted reproductive therapy
Authors: Bhaduri Mahua , Gama Rouvick M. , Copeland T. , Balagamage Alokya , Patel Priya , Warmington Emily , Sarris Ippokratis , Nicholaides Kypros , Bramham Kate
Published: November 2022

Background

As awareness around infertility is increasing among patients with chronic kidney disease (CKD), ever more of them are seeking Assisted Reproductive Technology (ART). Our aim was to perform a systematic review to describe obstetric and renal outcomes in women with CKD following ART.

Methods

The following databases were searched from 1946 to May 2021: (1) Cochrane Central Register of Controlled Trials (CENTRAL), (2) Cumulative Index to Nursing and Allied Health Literature (CINAHL), (3) Embase and (4) MEDLINE.

Results

The database search identified 3520 records, of which 32 publications were suitable. A total of 84 fertility treatment cycles were analysed in 68 women. Median age at time of pregnancy was 32.5 years (IQR 30.0, 33.9 years). There were 60 clinical pregnancies resulting in 70 live births (including 16 multifetal births). Four women developed ovarian hyperstimulation syndrome which were associated with acute kidney injury. Hypertensive disorders complicated 26 pregnancies (38.3%), 24 (35.3%) pregnancies were preterm delivery, and low birth weight was present in 42.6% of pregnancies. Rates of live birth and miscarriage were similar for women with CKD requiring ART or having natural conception. However, more women with ART developed pre-eclampsia (p < 0.05) and had multifetal deliveries (p < 0.001), furthermore the babies were lower gestational ages (p < 0.001) and had lower birth weights (p < 0.001).

Conclusion

This systematic review represents the most comprehensive assessment of fertility outcomes in patients with CKD following ART. However, the high reported live birth rate is likely related to reporting bias. Patient selection remains crucial in order to maximise patient safety, screen for adverse events and optimise fertility outcomes.
Hommage to Chentsov’s theorem
Authors: Fujiwara Akio
Published: November 2022

Chentsov’s theorem, which characterises Markov invariant Riemannian metric and affine connections of manifolds of probability distributions on finite sample spaces, is undoubtedly a cornerstone of information geometry. This article aims at providing a comprehensible survey of Chentsov’s theorem as well as its modest extensions to generic tensor fields and to parametric models comprising continuous probability densities on $${\mathbb R}^k$$

R

k

.
Assessment of Nitrogen Management on Sunflower Yield and Its Economic Response in Smallholder Farms in a Semi-Arid Region
Authors: Vilvert Elisa , Zander Peter , Mgeni Charles Peter , Sieber Stefan , Lana Marcos A.
Published: November 2022

Although sunflower production in Tanzania is increasing, smallholder farmers still face a number of constraints that result in poor yields. Lack or inadequate nutrient supply is one of the main factors limiting crop productivity in Tanzania. However, mineral fertilizer is not always easily available and not economically affordable by smallholder farmers. Therefore, the use of animal manure could be a feasible and financially viable alternative, especially in the Dodoma region, where there is abundant livestock production. The aim is to analyze the effects of different animal manure rates on sunflower yield and the economic response of smallholder farms from Dodoma region. The dataset used in this study was obtained from a 2-year in loco survey. Sunflower yields under different animal manure rates were obtained using a process-based biophysical model, and results linked to an economic assessment. Results considering the 2015 and 2045 period showed a positive effect of animal manure application in sunflower yield (866.8 kg ha−1) under manure rate limiting 5000 kg ha−1. The high rates of animal manure showed a decrease on yield providing evidence that water stress becomes the main limit factor for sunflower growth. Taking the economic assessment into account, an animal manure rate of 3000–5000 kg ha−1 is the most appropriate fertilization management under the environmental and social conditions of Dodoma region, providing a profitable financial return to the farmers (283–416 USD ha−1). Therefore, sunflower is an attractive cash crop for Tanzanian farmers when the soil fertilization is properly managed.
Understanding the Reasons Why Men and Women Do Not Donate Gametes
Authors: Whyte Stephen , Chan Ho Fai , Ferguson Nikita , Godwin Megan , Hammarberg Karin , Torgler Benno
Published: November 2022

The global under-supply of sperm and oocyte donors is a serious concern for assisted reproductive medicine. Research has explored self-selected populations of gamete donors and their ex-post rationalisations of why they chose to donate. However, such studies may not provide the necessary insight into why the majority of people do not donate. Utilising the unique open form responses of a large sample (n = 1035) of online survey respondents, we examine the reasons participants cite when asked: “Why haven’t you donated your sperm/eggs?.” We categorise these responses into four core themes (conditional willingness, barriers, unconsidered, and conscientious objector) and eleven lower-order themes. We find that, on average, women are more conditionally willing (8.2% difference; p = 0.008) to participate in gamete donation than men. We also find that women are more likely than men to justify their non-donation based on their reproductive history (21.3% difference; p = 0.000) or kin selection and inclusive fitness (5.7% difference; p = 0.008). However, compared to women, men are more likely to validate their non-donation based on sociocultural or social norms (6% difference; p = 0.000) or religion (1.7% difference; p = 0.030). That so many of our study participants report in-principal willingness for future participation in gamete donation speaks to the need for increased research on understanding non-donor population preferences, motivations, and behaviours.
A review of the joint replenishment problem from 2006 to 2022
Authors: Peng Lu , Wang Lin , Wang Sirui
Published: November 2022

In the increasingly competitive market, supply chain decision-makers are making efforts to improve operational efficiency and reduce costs by joint replenishment approach. Recognizing the value of joint replenishment strategy in the supply chain, we are motivated to write a review on the importance of joint replenishment strategy. Despite the vast literature on the joint replenishment problem (JRP), a comprehensive study survey for recent years is lacking. The goal of this study  is to review and synthesize research on JRP from 2006 to 2022. Details of JRP are introduced first. Literature selection and an overview of the extant literature are then discussed. Recent research on JRP with relaxed assumptions is summarized, including stochastic demand, dynamic demand, and resource constraints. In addition, recent research on other JRPs and the joint replenishment and delivery (JRD) problem is summarized. The observations and insights of these studies can guide academics and practitioners to implement joint replenishment strategies in different aspects of supply chain management.
Forecasting Sales Profiles of Products in an Exceptional Context: COVID-19 Pandemic
Authors: Sleiman Rita , Mazyad Ahmad , Hamad Moez , Tran Kim-Phuc , Thomassey Sébastien
Published: November 2022

Accurate demand forecasting has always been essential for retailers in order to be able to survive in the highly competitive, volatile modern market. However, anticipating product demand is an extremely difficult task in the context of short product life cycles in which consumer demand is influenced by many heterogeneous variables. During the COVID-19 pandemic in particular, with all its related new constraints, the fashion industry has seen a huge decline in sales, which makes it difficult for existing sales forecasting methods to accurately predict new product sales. This paper proposes an original sales forecasting framework capable of considering the effect of the COVID-19 related crisis on sales. The proposed framework combines clustering, classification, and regression. The main goals of this framework are (1) to predict a sales pattern for each item based on its attributes and (2) to correct it by modelling the impact of the crisis on sales. We evaluate our proposed framework using a real-world dataset of a French fashion retailer with Omnichannel sales. Despite the fact that during the lockdown period online sales were still possible, consumer purchases were significantly impacted by this crisis. Experimental analysis show that our methodology learns the impact of the crisis on consumer behavior from online sales, and then, adapts the sales forecasts already obtained.
High-resolution time- and angle-resolved photoemission studies on quantum materials
Authors: Huang Chaozhi , Duan Shaofeng , Zhang Wentao
Published: November 2022

Upon femtosecond laser excitation in quantum materials, it is possible to study the many-body interactions through the non-equilibrium processes, realize ultrafast electronic phase transitions, and achieve photoinduced novel states or hidden states. Such studies of the interaction between the ultrafast laser and the quantum materials are the frontiers and attract significant research interests in the field of condensed matter physics. Time- and angle-resolved photoemission spectroscopy is a key experimental tool to study the ultrafast electronic dynamics in quantum materials after photoexcitation. This paper reviews the development of a high-resolution time- and angle-resolved photoemission system based on nonlinear optical crystals and the studies on the ultrafast electronic dynamics in quantum materials using such a setup, including (1) probing the unoccupied electronic states in quantum materials, (2) photoinduced ultrafast electronic phase transitions, and (3) photoinduced new states of matter.
Dicing with Death
Authors: Senn Stephen
Published: November 2022

As a result of the COVID-19 pandemic, medical statistics and public health data have become staples of newsfeeds worldwide, with infection rates, deaths, case fatality and the mysterious R figure featuring regularly. However, we don't all have the statistical background needed to translate this information into knowledge. In this lively account, Stephen Senn explains these statistical phenomena and demonstrates how statistics is essential to making rational decisions about medical care. The second edition has been thoroughly updated to cover developments of the last two decades and includes a new chapter on medical statistical challenges of COVID-19, along with additional material on infectious disease modelling and representation of women in clinical trials. Senn entertains with anecdotes, puzzles and paradoxes, while tackling big themes including: clinical trials and the development of medicines, life tables, vaccines and their risks or lack of them, smoking and lung cancer, and even the power of prayer.
Variations in Sex Development
Authors: Liao Lih-Mei
Published: November 2022

Biological variations in sex development, also known as intersex, are greatly misunderstood by the wider public. This unique book discusses psychological practice in healthcare for people and families impacted by a range of 'intersex' variations. It highlights the dilemmas facing individuals and their loved ones in the social context and discusses the physical and psychological complexities of irrevocable medical interventions to approximate social norms for bodily appearance and function. It exposes the contradictions in medical management and suggests valuable theoretical and practice tools for psychosocial care providers to navigate them. Uniquely featuring theory and research informed practice vignettes, the book explores interpersonal work on the most salient psychosocial themes, ranging from grief work with impacted caretakers to sex therapy with impacted adults. An indispensable resource for working ethically, pragmatically and creatively for a variety of healthcare specialists and those affected by variations in sex development and their families and communities.
Monetary Redress for Abuse in State Care
Authors: Winter Stephen
Published: November 2022

Investigating a fast-developing field of public policy, Stephen Winter examines how states redress injuries suffered by young people in state care. Considering ten illustrative exemplar programmes from Australia, Canada, Ireland, and Aotearoa New Zealand, Winter explores how redress programmes attempt to resolve the anguish, injustice, and legacies of trauma that survivors experience. Drawing from interviews with key stakeholders and a rich trove of documentary research, this book analyses how policymakers should navigate the trade-offs that survivors face between having their injuries acknowledged and the difficult, often retraumatising, experience of attaining redress. A timely critical engagement with this contentious policy domain, Winter presents empirically driven recommendations and a compelling argument for participatory, flexible, and survivor-focussed programmes. This title is also available as Open Access on Cambridge Core.
Macroeconomics for Emerging East Asia
Authors: Wiemer Calla
Published: November 2022

Macroeconomics for Emerging East Asia presents a distinctive approach to the study of macroeconomic theory and policy. The author develops a unique analytical framework that incorporates: (1) both internal and external balance as aspects of macroeconomic stability; (2) both the exchange rate and the interest rate as monetary policy instruments, (3) government debt sustainability as a concern of fiscal policy, and (4) global capital flows as a force to be reckoned with. The framework provides students with the foundational knowledge to analyze macroeconomic issues common to emerging economies. Concepts are illustrated using the latest empirical data and extensive case study analysis for thirteen economies of Northeast and Southeast Asia (Cambodia, China, Hong Kong, Indonesia, Korea, Laos, Myanmar, Malaysia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam). The book's lucid exposition accommodates students of differing levels of preparation.
Impact on Vectran/Epoxy composites: Experimental and numerical analysis
Authors: Syed Abdullah S.I.B. , Iannucci L. , Greenhalgh E.S. , Yusof F.
Published: November 2022

The aim of this paper is to present a plane-stress damage model based on the Classical Lamination Theory (CLT), developed for polymer fibre-based composite. The proposed numerical model utilises a damage mechanics methodology coupled with fracture mechanics to predict composite failure, particularly under quasi-static and dynamic loadings. In addition, the proposed constitutive equations consider a single secant modulus to describe its tensile and compressive modulus, as opposed to the physically proposed tier models for polymer fibres which possesses a ‘skin-core’ structure. The result of single element and coupon-level modelling showed excellent correlation with the experimental results. In addition, it was also found that the proposed numerical model showed considerable accuracy on the response of the composite under low and high velocity impact loadings.
Coloniality of Power and Coloniality of Gender: Sentipensar the Struggles of Indigenous Women in Abya Yala from Worlds in Relation
Authors: Cariño Carmen , Montelongo González Alejandro
Published: November 2022

In this work I reflect, from the concepts of coloniality of power (Quijano 2007a) and coloniality of gender (Lugones 2008), key elements to sentipensar,2 the struggles of Indigenous women on the continent in defense of life in their territories. It is not new for Indigenous women to mobilize together with their peoples to defend the land-territory-life, but in recent years their participation has become more visible to the extent that the threat to the territories also involves fundamental elements for the reproduction of life that previously had not been of interest to capital. In this context my interest is focused on the ways in which the women of the territories create and resist from other ontologies in defense of life.

Thinking the reality of our countries from the coloniality of power and the coloniality of gender implies, among other things, taking as a baseline the existence of structures of domination, exploitation, and extermination that have been reproduced over the last five centuries in Abya Yala, and that have led to the imposition of a world classification that denies the existence of other worlds that inhabit these territories, and that have been persecuted, massacred, made invisible, but that exist and re-exist (Albán 2013).
Three-dimensional effects of cascade perforations on rotor–stator interaction noise
Authors: Shen Zihan , Wang Xiaoyu , Sun Yu , Zhang Guangyu , Sun Xiaofeng
Published: November 2022

One novel trend in reducing aero-engine noise is to utilize the silent flight mechanism of owls by applying perforations on fan stator vanes. Consequently, the establishment of relevant theoretical models is of particular interest. The current efforts made in this regard are just targeting the features based on two-dimensional models without including the three-dimensionality. In this paper, we present a three-dimensional solution for acoustic scattering by annular perforated cascades, and the dipole source corresponding to the unsteady pressure loading on the vanes is identified as the dominant sound source. By the singularity method, the acoustic response is obtained with the soft boundary condition applied on the vane surfaces. It is found that considerable noise reduction can be achieved for rotor–stator interaction with a modest uniform porosity, and accordingly two mechanisms are proposed to understand the effect of porosity on propagating sound. The first is that the perforations allowing a normal velocity across the vane reduce the unsteady loading induced by the incident disturbances. The second is that the three-dimensional interactions among the dipole sources at different positions are also dampened by the soft boundaries, thus the distribution of the unsteady pressure loading on the vanes will also change significantly compared to hard-vane cases. Non-uniform distributions of porosity are investigated further, indicating that perforations in the vane upstream area are more effective in reducing propagating noise. Our method is fully three-dimensional and capable of investigating non-uniform porosity, and thus is able to provide useful guidance for future soft vane designs.
Local Legal Strategies to Increase Vaccination During the COVID-19 Pandemic — Lessons from New York City
Authors: Landau Lisa , Stark Naomi , Chokshi Dave A.
Published: November 2022

Vaccine mandates played a critical role in the success of New York City’s COVID-19 response. By relying on evidence as a substantive basis for the mandates and adhering to procedural requirements and precedent, New York City leveraged its position and expertise as a local governmental authority to devise mandatory vaccine policies that withstood numerous legal challenges. New York City’s experience highlights the role of municipal government in mounting a meaningful public health response, and the strategies adopted by NYC may provide a blueprint for municipalities around the world facing the ongoing COVID-19 pandemic and the threat of future public health emergencies.
Unbending the Light: Changing Laws and Policies to Make Transgender Health Visible; Reflections of an Advocate
Authors: Green Jamison
Published: November 2022

This essay describes an instrumental advocate’s development, engagement, and accomplishments in transgender health at the intersection of law and medicine. Reflecting on the evolution of insurance policy reforms in conjunction with the need to increase the availability of clinicians who can understand and respectfully treat transgender patients, the author demonstrates how visibility, tenacity, and ingenuity can create far-reaching change.
Revisiting the Ethics of Circumvention Tourism
Authors: Snyder Jeremy C.
Published: November 2022

In the context of medical tourism, circumvention tourism consists of traveling abroad with the intention of participating in a health-related activity that is prohibited in one’s own country but not in the destination country. This practice raises a host of legal and ethical questions that focus on how the traveler should be treated once they have returned home. Joshua Shaw1 deftly shows that the question of whether circumvention tourists should be punished in their home countries is not something that can be answered in principle and without reference to the prima facie morality of the prohibition. This implicates formalist accounts of circumvention tourism developed by Pennings2 and Huxtable3 that argue against punishing travelers who access fertility treatments and medical assistance in dying abroad on the grounds that civic peace and stability require opportunities for individuals to travel internationally to access domestically prohibited medical services.
A Response to The Flaw in Formalist Accounts of Circumvention Tourism
Authors: Cohen I. Glenn
Published: November 2022

It is a huge pleasure to engage with Prof. Shaw’s careful and close reading of my article. Though almost a decade old, many of the issues are becoming only more relevant as it seems that Roe v Wade will be overruled in the U.S. and travel for abortion will become a sad reality.1 I appreciate how deeply Prof. Shaw interacts with my article and am full of praise for his work, but given the small space allocated here I only focus on our few places of disagreement.
Disaggregating geodetic glacier mass balance to annual scale using remote-sensing proxies
Authors: Banerjee Argha , Singh Ujjwal , Sheth Chintan
Published: November 2022

Decadal-scale, high-resolution geodetic measurements of glacier thinning have transformed our understanding of glacier response to climate change. Annual glacier mass balance can be estimated using remote-sensing proxies like snow-line altitude. These methods require field data for calibration, which are not available for most glaciers. Here we propose a method that combines multiple remotely-sensed proxies to obtain robust estimates of the annual glacier-wide balance using only remotely-sensed decadal-scale geodetic mass balance for calibration. The method is tested on Chhota Shigri, Argentière and Saint-Sorlin glaciers in the Himalaya and the Alps between 2001 and 2020, using four remotely-sensed proxies – the snow-line altitude, the minimum summer albedo over the glacier and two statistics of normalised difference snow index over the off-glacier area around the ablation zone. The reconstructed mass balance compares favourably with the corresponding glaciological field data (correlation coefficient 0.81 − 0.90, p < 0.001; root mean squared error 0.38 − 0.43 m w.e. a−1). The method presented may be useful to study interannual variability in mass balance on glaciers where no field data are available.
A semi-automated, GIS-based framework for the mapping of supraglacial hydrology
Authors: Bash Eleanor A , Shellian Colette , Dow Christine F , Mcdermid Greg , Kochtitzky Will , Medrzycka Dorota , Copland Luke
Published: November 2022

Supraglacial drainage networks play an integral role in both glacier dynamics and run-off timing, and mapping them provides insight into their role in glacial systems. Here we present a reproducible approach for semi-automated mapping of supraglacial hydrologic features, which complements existing work in automated and manual mapping by providing clear definitions for identification of features. This framework uses a digital terrain model (DTM) to identify potential flow routes on the glacier surface, which are then classified using a set of standardized rules based on the DTM and an orthomosaic. We found that the normalized difference water index calculated from digital imagery was influenced by image brightness and introduce a new approach using average RGB values to correct for this. Using this framework we mapped supraglacial drainage networks at Nàłùdäy and Thores Glacier, Canada. The framework was easier to implement with high-resolution (0.5 m) imagery and DTMs, compared to data with lower resolution (10 m), due to the increased detail in topography and feature boundaries at high-resolution. Lower-resolution data captured larger streams (>2 pixels wide), however, indicating that the framework can still be used at this resolution. Mapping supraglacial hydrology using standardized methods opens possibilities for investigating many questions relating to changes in supraglacial hydrology over time.
Time-convergent random matrices from mean-field pinned interacting eigenvalues
Authors: Mengütürk Levent Ali
Published: November 2022

We study a multivariate system over a finite lifespan represented by a Hermitian-valued random matrix process whose eigenvalues (i) interact in a mean-field way and (ii) converge to their weighted ensemble average at their terminal time. We prove that such a system is guaranteed to converge in time to the identity matrix that is scaled by a Gaussian random variable whose variance is inversely proportional to the dimension of the matrix. As the size of the system grows asymptotically, the eigenvalues tend to mutually independent diffusions that converge to zero at their terminal time, a Brownian bridge being the archetypal example. Unlike commonly studied random matrices that have non-colliding eigenvalues, the proposed eigenvalues of the given system here may collide. We provide the dynamics of the eigenvalue gap matrix, which is a random skew-symmetric matrix that converges in time to the
$\textbf{0}$
matrix. Our framework can be applied in producing mean-field interacting counterparts of stochastic quantum reduction models for which the convergence points are determined with respect to the average state of the entire composite system.
Imaginative processes in children are not particularly imaginative
Authors: Weisberg Deena Skolnick , Sobel David M.
Published: November 2022

The authors argue that children prefer fictions with imaginary worlds. But evidence from the developmental literature challenges this claim. Children's choices of stories and story events show that they often prefer realism. Further, work on the imagination's relation to counterfactual reasoning suggests that an attraction to unrealistic fiction would undermine the imagination's role in helping children understand reality.
Simulation, stories, and fictional worlds
Authors: Hogan Patrick Colm
Published: November 2022

The authors explain our attraction to strange, literary places as resulting from our attraction to strange places in real life. I believe this is correct and important. The aim of the following commentary is to show that their main conclusion is closely related to – even (retrospectively) predictable from – the operation of simulation and the consequences of that operation for storytelling.
Imagining our moral values in the present and future
Authors: Wylie Jordan , Alto Alix , Gantman Ana
Published: November 2022

Imaginary worlds allow us to safely develop, crystallize, and criticize our moral values – at times even serving as catalysts for change in the real world. Fans of imaginary worlds sometimes form groups to advocate for social change in the real world, and it is part of Leftist ideology to imagine radically different, possible futures aligned around shared moral values.
Using imaginary worlds for real social benefits
Authors: Gabriel Shira , Green Melanie C. , Naidu Esha , Paravati Elaine
Published: November 2022

We argue that imaginary worlds gain much of their appeal because they fulfill the fundamental need of human beings to feel connected to other humans. Immersion into story worlds provides a sense of social connection to the characters and groups represented in the world. By fulfilling the need to belong, imaginary worlds provide a buffer against rejection and loneliness.
Autism and the preference for imaginary worlds
Authors: Browning Heather , Veit Walter
Published: November 2022

Dubourg and Baumard mention a potential role for the human drive to systemise as a factor motivating interest in imaginary worlds. Given that hyperexpression of this trait has been linked with autism (Baron-Cohen, 2002, 2006), we think this raises interesting implications for how those on the autism spectrum may differ from the neurotypical population in their engagement with imaginary worlds.
Student support and teacher education in English for Academic Purposes and English Medium Instruction: Two sides of the same coin?
Authors: Wingate Ursula
Published: November 2022

The massive increase in the use of English Medium Instruction (EMI) in universities around the world has been accompanied by an ever-growing body of publications. The majority focus on EMI policies, teacher identities, and teachers’ and students’ attitudes towards EMI, whilst there seems to be little research into pedagogical approaches to language and literacy support for students as well as into practices in EMI teacher education, areas that are fundamental to the successful delivery of EMI. Recommendations come predominantly from conceptual papers (e.g. Dafouz, 2018, 2021; Galloway & Rose, 2021; Lasagabaster, 2018), and it is noticeable that some of these papers, in line with other EMI publications, rarely draw on English for Academic Purposes (EAP), a field that offers a rich set of theories and practices relating to student support and teacher education that are based on a decades-old research history.
Incidental Findings from Deep Phenotyping Research in Psychiatry: Legal and Ethical Considerations
Authors: Kim Amanda , Hsu Michael , Koire Amanda , Baum Matthew L.
Published: November 2022

Substantial advancement in the diagnosis and treatment of psychiatric disorders may come from assembling diverse data streams from clinical notes, neuroimaging, genetics, and real-time digital footprints from smartphones and wearable devices. This is called “deep phenotyping” and often involves machine learning. We argue that incidental findings arising in deep phenotyping research have certain special, morally and legally salient features: They are specific, actionable, numerous, and probabilistic. We consider ethical and legal implications of these features and propose a practical ethics strategy for managing them.
Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation for Traumatic Brain Injury Study: Part I
Authors: Fins Joseph J. , Wright Megan S. , Henderson Jaimie M. , Schiff Nicholas D.
Published: November 2022

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023.
Using Antipsychotics for Self-Defense Purposes by Care Staff in Residential Aged Care Facilities: An Ethical Analysis
Authors: Soofi Hojjat
Published: November 2022

People with dementia at times exhibit threatening and physically aggressive behavior toward care staff in residential aged care facilities (RACFs). Current clinical guidelines recommend judicious use of antipsychotic (AP) medications when there is an immediate risk of harm to care staff in RACFs and non-pharmacological interventions have failed to avert the threats. This article examines an account of how this recommendation can be ethically defensible: caregivers in RACFs may have a prima facie ethical justification, in certain cases, to use APs as an act of self-defense. The author examines whether such uses of APs meet the three commonly invoked conditions of ethically permissible acts of self-defense—namely, the conditions of liability, proportionality, and necessity—and argues that such conditions obtain only in a restricted range of cases. The liability constraint can be satisfied if residents are the only ones who are causally responsible for the threats they pose. Further, the condition of proportionality obtains if there is sufficient objective ground to demonstrate that the harm of using the medications does not outweigh the good to be secured. Lastly, the necessity condition obtains when the medications are used at their lowest effective dosage and caregivers in RACFs can reasonably assume that, for the purpose of averting threats posed by residents, the use of APs is the only available course of action. Not meeting any of these fairly stringent conditions renders uses of APs as acts of self-defense in RACFs morally impermissible actions.
Persistent left superior vena cava draining into the unroofed coronary sinus in a patient with tetralogy of Fallot and coronary sinus orifice atresia
Authors: Selcuk Arif , Korun Oktay , Sasmazel Ahmet
Published: November 2022

Introduction:

In this study, we present a case of directing persistent left superior vena cava drainage into the unroofed coronary sinus to the right atrium in a patient with tetralogy of Fallot and coronary sinus orifice atresia without innominate vein.

Case report:

A 16-month-old boy diagnosed with tetralogy of Fallot was admitted. Following intracardiac repair, the left superior vena cava was divided from the left atrial junction, passed through under the ascending aorta and anastomosed to the right superior vena cava.

Conclusion:

To our knowledge, this is the first patient reported with persistent left superior vena cava, unroofed coronary sinus, coronary sinus orifice atresia, and tetralogy of Fallot. The extracardiac direct anastomosis technique was used successfully to direct persistent left superior vena cava to the right atrium without any post-procedure complications
Heart failure in a newborn with tetralogy of Fallot: uncommon association of a common anomaly
Authors: Kakarla Saikiran , Sasikumar Deepa , Dharan Baiju S.
Published: November 2022

Heart failure in tetralogy of Fallot in the newborn period is rare and is usually due to either large aortopulmonary collaterals or absent pulmonary valve syndrome with severe pulmonary regurgitation. Pink tetralogy of Fallot and tetralogy of Fallot with disconnected pulmonary arteries from the aorta may present beyond the newborn period with heart failure when Pulmonary vascular resistance (PVR) falls. We describe the diagnostic and therapeutic pathway in a rare case of heart failure in newborn with tetralogy of Fallot.
Reward functioning from an attentional perspective and obsessive-compulsive symptoms—an eye-tracking study
Authors: Basel Dana , Lazarov Amit
Published: November 2022

Background

Recently, a novel approach to obsessive-compulsive disorder has emerged, implicating altered reward functioning in the disorder. Yet, no study to date has directly examined the attentional aspect of reward functioning in participants with obsessive-compulsive (OC) symptoms, with past research mostly relying on reaction-time-based tasks.

Methods

A reward-based value-modulated attentional capture task was completed by a sample of nonclinical student participants—44 with high (HOC) and 48 with low (LOC) levels of OC symptoms. We measured the extent to which high and low reward-signaling distractors captured attention and impaired performance on the task, resulting in a lower possibility of obtaining a monetary reward. Attentional capture was indexed via fixation data, and further explored using saccade data.

Results

Both groups performed more poorly when a high-reward signaling distractor was present, compared to when a low-reward signaling distractor was present. Importantly, this difference was significantly greater in the HOC group, and was found to be driven by the specific effects of reward-signaling distractors. Similar results emerged when exploring saccade data, and remained significant after controlling for both addiction-related compulsivity and depressive symptoms.

Conclusions

Current findings suggest that attentional reward-related functioning may be associated with OC symptoms. Different aspects of reward functioning, including attention, should be further explored and incorporated into future research and clinical endeavors.
Comparison of inpatient and outpatient palliative sedation practice – A prospective observational study
Authors: Buchhold Britta , Jülich Andreas , Glöckner Franziska , Neumann Thomas , Schneidewind Laila , Schmidt Christian-Andreas , Heidel Florian H. , Krüger William H.
Published: November 2022

Introduction

Palliative sedation (PS) is an intrusive measure to relieve patients at the end of their life from otherwise untreatable symptoms. Intensive discussion of the advantages and limitations of palliative care with the patients and their relatives should precede the initiation of PS since PS is terminated by the patient’s death in most cases. Drugs for PS are usually administered intravenously. Midazolam is widely used, either alone or in combination with other substances. PS can be conducted in both inpatient and outpatient settings; however, a quality analysis comparing both modalities was missing so far.

Patients and methods

This prospective observational study collected data from patients undergoing PS inpatient at the palliative care unit (PCU, n = 26) or outpatient at a hospice (n = 2) or at home (specialized outpatient palliative care [SAPV], n = 31) between July 2017 and June 2018. Demographical data, indications for PS, and drug protocols were analyzed. The depth of sedation according to the Richmond Agitation Sedation Scale (RASS) and the degree of satisfaction of staff members and patient’s relatives were included as parameters for quality assessment.

Results

Patients undergoing PS at the PCU were slightly younger compared to outpatients (hospice and SAPV combined). Most patients suffered from malignant diseases, and midazolam was the backbone of sedation for inpatients and outpatients. The median depth of sedation was between +1 and −3 according to the RASS with a trend to deeper sedation prior to death. The median degree of satisfaction was “good,” scored by staff members and by patient’s relatives. Significant differences between inpatients and outpatients were not seen in protocols, depth of sedation, and degree of satisfaction.

Conclusion

The data support the thesis that PS is possible for inpatients and outpatients with comparable results. For choosing the best place for PS, other aspects such as patient’s and relative’s wishes, stress, and medical reasons should be considered.
Simulated Long‐Term Evolution of the Ionosphere During the Holocene
Authors: Yue Xinan , Cai Yihui , Ren Zhipeng , Zhou Xu , Wei Yong , Pan Yongxin
Published: November 2022

To date, no natural media is available to derive the “ancient” ionosphere, so the current understanding of ionospheric long‐term trends mainly comes from analyzing ∼70 yr modern measurements supplemented by theoretical simulations. In this study, for the first time, we expanded the ionosphere simulation to the whole Holocene (9455 BCE to 2015 CE) using the Global Coupled Ionosphere‐Thermosphere‐Electrodynamics Model developed at the Institute of Geology and Geophysics, Chinese Academy of Sciences, driven by a realistic geomagnetic field, CO2 level, and solar activity, all of which are a combination of ancient media derivations and modern observations. Through a series of control runs, we found that the ionospheric oscillation of the global mean profile is characterized by a nonlinear variation versus geomagnetic field effect, a decrease (increase) above (below) ∼200 km due to CO2 increase, and violent oscillations in phase with changes in solar activity, with corresponding contributions of approximately 20%, 20%, and 60%, respectively. The CO2 effect became nonnegligible and even more significant after ∼1800 CE. The solar activity effect is marked by a frequently occurring grand solar minimum. The ionospheric characteristics show linear variations versus the dipole moment of the geomagnetic field, the CO2 level, and the F10.7 index, with the growth rate having significant local time and latitude variations. Our prediction shows that a 400 ppm CO2 increase will cause a global mean decrease of 1.2 MHz in foF2, 34 km in hmF2, and 4 tecu in TEC, which will directly influence radio wave communication.
Deriving Three‐Dimensional Properties of Fracture Networks From Two‐Dimensional Observations in Rocks Approaching Failure Under Triaxial Compression: Implications for Fluid Flow
Authors: McBeck Jessica , Renard François
Published: November 2022

Approximating the three‐dimensional structure of a fault network at depth in the subsurface is key for robust estimates of fluid flow. However, only observations of two‐dimensional outcrops are often available. To shed light on the relationship between two‐ and three‐dimensional measurements of fracture networks, we examine data from a unique set of 11 X‐ray synchrotron triaxial compression experiments that reveal the evolving three‐dimensional fracture network throughout loading. Using machine learning, we derive relationships between the two‐ and three‐dimensional measurements of three properties that control fluid flow: the porosity, and volume and tortuosity of the largest fracture at a particular differential stress step. The models predict the porosity and volume of the largest fracture with R2 scores of >0.99, but predict the tortuosity with maximum R2 scores of 0.68. To test the assumption that different rock types may require different equations between the two‐ and three‐dimensional properties, we develop models for both individual rock types (granite, monzonite, marble, sandstone) and all of the experiments. Models developed using all of the experiments perform better than models developed for individual rock types, suggesting fundamental similarities between fracture networks in rocks often analyzed separately. Models developed with several parallel two‐dimensional observations perform similarly to models developed with several perpendicular two‐dimensional observations. When the models are developed with statistics of the two‐dimensional observations, the models primarily depend on the mean and median when they predict the porosity, and minimum when they predict the volume and tortuosity.
Identification of key biomarkers for STAD using filter feature selection approaches
Authors: Wang Yangyang , Wang Jihan , Hu Ya , Shangguan Jingbo , Song Qiying , Xu Jing , Wang Hanping , Xue Mengju , Wang Liping , Zhang Yuanyuan
Published: November 2022

Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer death worldwide. Discovery of diagnostic biomarkers prompts the early detection of GC. In this study, we used limma method combined with joint mutual information (JMI), a machine learning algorithm, to identify a signature of 11 genes that performed well in distinguishing tumor and normal samples in a stomach adenocarcinoma cohort. Other two GC datasets were used to validate the classifying performances. Several of the candidate genes were correlated with GC tumor progression and survival. Overall, we highlight the application of feature selection approaches in the analysis of high-dimensional biological data, which will improve study accuracies and reduce workloads for the researchers when identifying potential tumor biomarkers.
Hyaluronan nanoscale clustering and Hyaluronan synthase 2 expression are linked to the invasion of child fibroblasts and infantile fibrosarcoma in vitro and in vivo
Authors: Tonge Joseph J. , Notley Scott V. , Dunning Mark J. , López-Guajardo Ana , Medcalf Jessica D. , Heldin Paraskevi , Panoutsos George , Gad Annica K. B.
Published: November 2022

Infantile fibrosarcoma is a rare childhood tumour that originates in the fibrous connective tissue of the long bones for which there is an urgent need to identify novel therapeutic targets. This study aims to clarify the role of the extracellular matrix component hyaluronan in the invasion of child fibroblasts and Infantile fibrosarcoma into the surrounding environment. Using nanoscale super-resolution STED (Stimulated emission depletion) microscopy followed by computational image analysis, we observed, for the first time, that invasive child fibroblasts showed increased nanoscale clustering of hyaluronan at the cell periphery, as compared to control cells. Hyaluronan was not observed within focal adhesions. Bioinformatic analyses further revealed that the increased nanoscale hyaluronan clustering was accompanied by increased gene expression of Hyaluronan synthase 2, reduced expression of Hyaluronidase 2 and CD44, and no change of Hyaluronan synthase 1 and Hyaluronidases 1, 3, 4 or 5. We further observed that the expression of the Hyaluronan synthase 1, 2 and 3, and the Hyaluronidase 3 and 5 genes was linked to reduced life expectancy of fibrosarcoma patients. The invasive front of infantile fibrosarcoma tumours further showed increased levels of hyaluronan, as compared to the tumour centre. Taken together, our findings are consistent with the possibility that while Hyaluronan synthase 2 increases the levels, the Hyaluronidases 3 and 5 reduce the weight of hyaluronan, resulting in the nanoscale clustering of hyaluronan at the leading edge of cells, cell invasion and the spread of Infantile fibrosarcoma.