bluuebunny/crossref_metadata_2025 huggingface dataset:
Information structure, functional left peripheries, and the history of a Hungarian interrogative marker
Authors: Bacskai-Atkari Julia
Published: August 2022

This article examines diachronic changes affecting functional left peripheries in Hungarian embedded polar interrogatives. While Old Hungarian embedded polar questions were introduced by an interrogative complementiser (ha ‘if’), similarly to Germanic languages, Modern Hungarian polar questions are marked by the clause-internal element -e. Middle Hungarian represents an intermediate stage in which both elements were present. There are two factors responsible for this change. First, Proto-Hungarian saw a major word order change from strict SOV to a much freer word order in which various left-peripheral positions were established, including that of the FP on top of the TP: this came to host wh-constituents and focussed elements. As a consequence, the overt marking of [Q] in constituent questions grammaticalized in the FP. Second, this had an analogical effect on polar questions, ultimately resulting in the grammaticalization of -e as an F head specified for overtly marking [Q].
The Gendered Framework of International Humanitarian Law and the Development of International Criminal Law
Authors: Jarvis Michelle , Gardam Judith
Published: August 2022

Women (and girls) are disproportionately adversely affected by armed conflict. Attempts to address these effects have been hindered by gender stereotypes and assumptions. This chapter analyses the role of gender in international humanitarian law (IHL) and international criminal law (ICL). The aim of the chapter is to show the connection between gender in IHL and ICL and to expose the challenges this creates in successfully responding to the effects of armed conflict on women. The chapter provides an overview of gender in the context of IHL prior to the development of ICL, including the failures of IHL to fully address the experiences of women in armed conflict. It then examines how gendered concepts in IHL have influenced and been incorporated into ICL. It addresses how IHL has hindered ICL with outdated gender concepts, as well as ways in which ICL has evolved these concepts.
The International Crimes of Slavery and the Slave Trade
Authors: Sellers Patricia Viseur , Kestenbaum Jocelyn Getgen
Published: August 2022

The 1926 Slavery Convention to Suppress Slavery and the Slave Trade outlawed slavery and the slave trade as international crimes. This chapter examines the legal definitions of slavery and the slave trade, using an in-depth look at the slaves themselves to understand the historic gendered and sexual elements of slavery and the slave trade. The authors suggest that intersectional realities ‘normalized’ these aspects of slavery and continue to permeate slavery and the slave trade today. This chapter further discusses the Rome Statute’s inclusion of sexual slavery as a separate crime. The authors posit that sexual slavery as an international crime is redundant and encompasses actions that are already outlawed under customary international law’s prohibitions of slavery and the slave trade.
Victory for Women and LGBTIQ+ Rights Under International Criminal Law
Authors: Davis Lisa , Bradley Danny
Published: August 2022

The authors contend that the Rome Statute’s definition of gender is opaque, which has hindered accountability for gender persecution, including for crimes committed against women and lesbian, gay, bisexual, transgender, intersex, queer, non-binary, or otherwise gender-non-conforming (LGBTIQ+) persons. This chapter illustrates how a coalition of advocates—led by MADRE, OutRight Action International, and the Human Rights and Gender Justice Clinic of the City University of New York School of Law—prevented the inclusion of this outdated definition into a proposed treaty dealing with crimes against humanity. It looks back to the Rome Statute and the women’s rights movement that laid the groundwork for the proposed new convention, and what these legal advancements mean for gender justice and equal rights.
Is International Criminal Law Particularly Impervious to Feminist Reconstruction?
Authors: Otto Dianne
Published: August 2022

This chapter focuses on the many resistances to feminist judging in international criminal law (ICL) courts and tribunals. The author canvases the history of feminism and criminal law, referencing a number of cautionary critiques and their resonance with feminist reform efforts in ICL. The chapter then examines the responses to feminist interventions by judges in three cases, from the International Criminal Tribunal for the former Yugoslavia (ICTY), the International Criminal Tribunal for Rwanda (ICTR), and the International Criminal Court (ICC), highlighting the corrosive charges of judicial activism and lack of impartiality that they have elicited. Finally, the author addresses critiques of judicial methods and procedures enacted by several non-governmental organization (NGO)-organized women’s tribunals, which nevertheless remain hopeful about enhanced legal justice in the present. This chapter attempts to highlight the conflict between ICL and feminism, while also recognizing that feminist engagement with ICL remains necessary because of law’s power to shape our realities.
Schopenhauer’s Transcendental Aesthetic
Authors: Hogan Desmond
Published: August 2022

Schopenhauer’s World as Will and Representation defends an idealism according to which space and time have no reality beyond the world of representation; both are “forms of knowledge, not qualities of the thing in itself.” The locus classicus of such idealism is Kant’s Critique of Pure Reason, a work regarded by Schopenhauer as the most important contribution to philosophy in two thousand years. He claims that Kant’s arguments for idealism, by wholly conquering the innate realism of our original disposition, produce an effect “like that of an operation for cataract on a blind man.” This epiphany is occasioned by the book’s Transcendental Aesthetic chapter, whose proofs have “a complete power of conviction,” and whose propositions “number among the incontestable truths.” Schopenhauer’s praise of Kant here is striking, not least because a broad consensus over two centuries has concluded that the Transcendental Aesthetic’s central argument for its idealist theory of space and time is a clear failure. Schopenhauer’s positive appraisal is usually taken to show that he too simply overlooked the fatal objection to the argument. It is argued that Schopenhauer saw exactly why the classical invalidity objection is mistaken—that he praised Kant’s argument for transcendental idealism because he understood it. His insight leads us to a deeper understanding of one of the pivotal arguments of Kant’s critical philosophy.
Kant on the Epistemology of the Obvious
Authors: Rosenkoetter Timothy
Published: August 2022

The launching point for this chapter is Kant’s striking claim that all and only mathematical cognition is “evident.” After proposing the hypothesis that “evident” propositions are a proper subset of “obvious” propositions (namely, the subset of the obvious grounded in a priori intuition), the chapter fills a lacuna in the secondary literature by developing a systematic account of when and why Kant conceives of this or that proposition as “obvious.” The core idea is that certainty regarding an obvious truth is accessible to any subject who possesses “common human understanding.” The fact that there are two modes of access available to a subject who currently lacks that certainty (or is outright mistaken)—one through rule-based instruction, the other through measures that regain the healthy use of common human understanding—partitions the obvious into two classes, including most of mathematics in the former class and truths such as the causal principle, basic moral principles, and tautologies in the latter. Overall, the chapter argues that Kant’s theory of the obvious plays a previously unrecognized role rationalizing and tying together disparate Kantian positions that might otherwise seem unimportant or merely idiosyncratic.
Kant’s One-World Phenomenalism
Authors: Chignell Andrew
Published: August 2022

The goal of this chapter is to sketch an account of Kant’s signature metaphysical doctrine (transcendental idealism) that (a) apparently has no supporters in the contemporary literature, and (b) draws its primary motivation (as interpretation) from considerations regarding our practical situation and needs as agents. The consideration focused on here is that people not only have mental and moral features but also appear to us—in our daily experience—to have such features. The same presumably goes for vice: Your character shines through in your actions, and I can then make a defeasible inference from those appearances to the moral reality. An interpretation of transcendental idealism that gives primacy to the practical will thus seek to analyze the concepts of experience, acquaintance, and appearance/phenomenon in a capacious enough way that they apply to mental and moral features too. “One-World Phenomenalism” does this by saying that there is just one set of real things, for Kant—namely, substances with their intrinsic and relational features. Some of the key features of these substances (like their moral features) are also features that they appear to us to have. They are “straddling” features. However, many of the features that they appear to us to have (spatio-temporal-causal features) are not features that they really have. If successful, such an interpretation would have a clear practical advantage over those that leave us merely conjecturing from experiences of bodies, gestures, and various secondary qualities to moral features that do not appear, or even to the non-appearing features of a distinct set of things.
Dynamic Changes in the Antioxidative Defense System in the Tea Plant Reveal the Photoprotection-Mediated Temporal Accumulation of Flavonoids under Full Sunlight Exposure
Authors: Zhang Qunfeng , Ruan Jianyun , Mumm Roland , de Vos Ric C H , Liu Mei-Ya
Published: August 2022

To reveal the mechanisms underlying how light affects flavonoid metabolism and the potential role of flavonoids in protecting against photooxidative stress in tea leaves, tea plants adapted to low-light conditions were exposed to full sunlight over 48 h. There was an increase in the activities of catalase (CAT) and superoxide dismutase (SOD) as well as greater accumulation of reactive oxygen species, lutein, tocopherols, ascorbate and malondialdehyde, suggestive of a time-dependent response to photooxidative stress in tea leaves. Analysis of the time dependency of each element of the antioxidant system indicated that carotenoids and tocopherols exhibited the fastest response to light stress (within 3 h), followed by SOD, CAT and catechin, which peaked at 24 h. Meanwhile, flavonols, vitamin C and glutathione showed the slowest response. Subsequent identification of the main phytochemicals involved in protecting against oxidative stress using untargeted metabolomics revealed a fast and initial accumulation of nonesterified catechins that preceded the increase in flavonol glycosides and catechin esters. Gene expression analysis suggested that the light-induced accumulation of flavonoids was highly associated with the gene encoding flavonol synthase. Ultraviolet B (UV-B) irradiation further validated the time-dependent and collaborative effects of flavonoids in photoprotection in tea plants. Intriguingly, the dynamics of the metabolic response are highly distinct from those reported for Arabidopsis, suggesting that the response to light stress is not conserved across plants. This study additionally provides new insights into the functional role of flavonoids in preventing photooxidative stress and may contribute to further improving tea quality through the control of light intensity.
Petrogenesis of continental intraplate alkaline basalts in the Tuoyun Basin, western Central Asian Orogenic Belt: implications for deep carbon recycling
Authors: Cheng Zhiguo , Zhang Zhaochong , Wang Zhenchao , Jin Ziliang , Hao Jinhua , Jin Lei , Santosh M
Published: August 2022

The origin of intraplate volcanic provinces in continental interiors remains equivocal. One of the major gaps is the absence of a clear understanding of thermal state and the role of recycled carbon. Here we present results from detailed temperature estimation, trace element content of olivine and integrated Sr-Nd-O-Mg-Zn isotopic studies on Meso-Cenozoic basalt and basanite from the Tuoyun Basin in the western Central Asian Orogenic Belt. The calculated crystallization temperatures are in the range of 1101-1273 °C for basalt and 1037-1295 °C for basanite, consistent with ambient upper mantle-derived melts. Olivine Zn/Fe, Mn/Zn and Fe/Mn ratios fall in the hybrid source region composed of peridotite and pyroxenite for both basalt and basanite, which is also in agreement with their bulk-rock CaO-MgO trends, FeO/MnO ratios (62.8-77.4 for basalt and 57.8-65.1 for basanite) and FCKANTMS values (overall major element compositions; 0.52-0.68 for basalt and 0.43-0.64 for basanite). Trace elemental modeling shows that the basalt was produced by higher degrees of partial melting with more pyroxenite contribution than basanite. Mg and Zn isotopes show lighter Mg (-0.45 to -0.55 ‰ for basalt and -0.45 to -0.47 ‰ for basanite) and heavier Zn (0.37-0.41 ‰ for basalt and 0.38 to 0.48 ‰ for basanite) isotopic compositions than primitive mantle, indicating the possible involvement of recycled sedimentary carbonate in mantle source. Conversely, the basalt and basanite lack typical “carbonatitic fingerprints” such as high CaO/Al2O3 ratios and negative Zr, Hf and Ti anomalies. Furthermore, the Sr-O isotopes display typical mantle-affinity without explicit crustal signatures. Such a decoupling is attributed to carbonate species transition and decarbonation reactions between carbonate and surrounding silicate during plate subduction at a depth of > 150 km where the following reactions take place: CaMg(CO3)2 (dolomite) = MgSiO3 (magnesite) + CaCO3 (aragonite), and MgCO3 (magnesite) + SiO2 (coesite) → MgSiO3 (enstatite) + CO2. When the recycled carbonates are exhausted, crustal Sr-O is released but the Mg-Zn isotopic anomalies are inherited by the silicate products (“ghost carbonate”). These silicates are expected to be involved in the subsequent mantle upwelling that induces decompression melting to generate intraplate magmas. We therefore propose recycled carbonates in the mantle sources of the Tuoyun lavas underwent recycling at depths > 150 km and were incorporated as “ghost carbonate” with recycled Mg and Zn elements in the partial melting process rather than directly in the carbonate form.
Brown Amphibole as Tracer of Tectono-Magmatic Evolution of the Atlantis Bank Oceanic Core Complex (IODP Hole U1473A)
Authors: Ferrando Carlotta , Tribuzio Riccardo , Lissenberg C Johan , France Lydéric , MacLeod Christopher J , Basch Valentin , Villeneuve Johan , Deloule Etienne , Sanfilippo Alessio
Published: August 2022

Brown amphibole is a minor but common mineral component in lower oceanic crust. It is generally interpreted as products of migrating SiO2 and H2O-rich fluids or melts, which can be either residual melts from advanced magmatic differentiation of Mid-Ocean Ridge Basalt (MORB), or hydrothermal fluids including a seawater component. Within the lower oceanic crust exhumed at the Atlantis Bank Oceanic Core Complex, along the ultraslow Southwest Indian Ridge, brown amphibole is ubiquitous in all lithologies from olivine- to oxide-gabbros and diorites, including both undeformed and plastically deformed varieties. We here show the results of a systematic petrological study conceived to unravel the nature of the H2O-rich component recorded in brown amphiboles and document: (i) the evolution of migrating melts during the magmatic stage and (ii) different extents of melt-bearing deformation events recorded throughout the entire crustal transect. The low Cl contents and the light over heavy rare earth elements (LREE/HREE) ratios and high Ti contents in brown amphiboles indicate they crystallized from melts with a magmatic hydrous component. Consistently, their δ18O values are in equilibrium with Mid-Ocean Ridge Basalt (MORB) composition, except for diorite amphiboles that possibly record the local assimilation of altered minerals. In undeformed olivine gabbros, interstitial pargasite crystallized at hypersolidus conditions (~1000°C) from the melt residual after late stages of MORB differentiation. We speculate that before the olivine gabbro crystal mush reached fully solid state, some aliquots of residual melts were extracted and accumulated within discrete intervals. There, ferrobasaltic melts differentiated through the early crystallization of Fe-Ti oxides and clinopyroxene as liquidus phases, ultimately forming the oxide gabbros. This process promoted rapid Si enrichment and depletion in Fe, Ti, V in the residual melt, later extracted to form the crosscutting diorite veins. The mylonitic olivine gabbros record high-temperature plastic deformation (~900°C ± 50°C) under hypersolidus conditions, involving melts residual from previous crystallization of the gabbroic rock. Further solid-state plastic deformation led to substantial grain size reduction and, consequently, to an increase in porosity. This created pathways for subsequent melt focusing, which likely represent late-stage differentiated melts migrating throughout the lower crustal section. This study shows that brown amphibole in the Atlantis Bank lower oceanic crust is the crystallization product of melts residual from advanced magmatic differentiation, which are also locally involved in the plastic deformation events during crustal accretion.
Experimental Pain Measurements Do Not Relate to Pain Intensity and Pain Cognitions in People Scheduled for Surgery for Lumbar Radiculopathy
Authors: Huysmans Eva , Goudman Lisa , Van Bogaert Wouter , Nijs Jo , Putman Koen , Moens Maarten , Buyl Ronald , Ickmans Kelly , Garcia Barajas Guillermo , Fernández-Carnero Josue , Coppieters Iris
Published: August 2022

Objective

The present cross-sectional study aims to unravel associations of pain intensity and cognitions with quantitative sensory testing in people scheduled for surgery for lumbar radiculopathy. Additionally, insight will be provided into the presence of dysfunctional nociceptive processing and maladaptive pain cognitions in this population.

Design

Cross-sectional study.

Setting

Data from three hospitals in Belgium.

Subjects

The final sample comprised 120 participants with lumbar radiculopathy scheduled for surgery, included between March 2016 and April 2019.

Methods

Self-reported pain intensity was assessed on a visual analog scale, and pain cognitions were assessed with self-reported questionnaires (Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Pain Vigilance and Awareness Questionnaire). Quantitative sensory testing (detection thresholds, pain thresholds, temporal summation, and conditioned pain modulation) was evaluated, as well.

Results

Evidence was found for the presence of an impaired inhibitory response to nociceptive stimuli and maladaptive pain cognitions in this population. Kinesiophobia was found to be present to a maladaptive degree in the majority of the patients (n = 106 [88%]). Significant, but weak, associations between electrical pain thresholds at the sural nerves and leg pain intensity (sural nerve symptomatic side: r = –0.23; P = 0.01; non-symptomatic side: r = –0.22; P = 0.02) and kinesiophobia levels (sural nerve non-symptomatic side: r = –0.26; P = 0.006) were identified.

Conclusions

Electrical detection thresholds and correlates for endogenous nociceptive facilitation and inhibition were not found to be related to any of the pain cognitions or to pain intensity in people scheduled to undergo surgery for lumbar radiculopathy.
Effective dose Estimation in Whole Body 18F-FDG PET/CT Imaging
Authors: Karimipourfard M , Sina S , Shobeiry M , Alavi M S , Faghihi R
Published: August 2022

Positron emission tomography–computed tomography (PET–CT) with internal administration of the FDG-18 is characterized as a widespread functional imaging modality in diagnostic radiation medicine, which increases the patient effective doses owing to the presence of internal and external radiation sources. Hence, patient effective dose estimation has been pinpointed as a significant factor in radiation protection assessment. A large number of studies have been published in this regard, and various dosimetry methods have been surveyed. According to our previous research, 10 patients had participated in PET–CT scans with three static time sequences imaging. PET effective doses were estimated using a simple method derived from Anderson et al. and Kaushik et al. coefficients, and the CT effective doses were surveyed with a CTDI phantom and cylindrical ionization chamber. The CT dose was tripled owing to the three static time-sequences imaging. The effective doses were calculated using different coefficients and the results of the PET effective doses were compared. The PET–CT effective dose was varied from 17.14 to 18.42 mSv based on Kaushik et al. coefficients which were measured for one low-dose CT scan. This study aimed to survey simple PET–CT effective dose estimation using three static-time imaging approaches which increases the total patient effective doses.
Direct Shock Experience vs. Tangential Shock Exposure: Indirect Effects of Flood Shocks on Well-Being and Preferences
Authors: Stein Wiebke , Weisser Reinhard A
Published: August 2022

With extreme weather events on the rise, the question of how witnessing adverse weather events may affect individuals’ perception, and consequently their subjective well-being, gains in relevance. To identify events that have been witnessed, i.e., tangential exposure to a weather shock, satellite-based data on flooding is linked to an extensive household panel survey from rural Southeast Asia. Contrasting direct shock experience with tangential shock exposure, we find that mere proximity to a potentially adverse shock, without reporting any actual direct shock experience, could be sufficient to reduce subjective well-being. This effect is not only restricted to the present but can also impinge on expected future well-being dynamics. Eventually, such a persistent effect from witnessing a weather shock may have further politico-economic repercussions, for instance, by altering support for redistribution policies.
Bacillus-Secreted Oxalic Acid Induces Tomato Resistance Against Gray Mold Disease Caused byBotrytis cinereaby Activating the JA/ET Pathway
Authors: Yu Yi-Yang , Si Fang-Jie , Wang Ning , Wang Ting , Jin Yu , Zheng Ying , Yang Wei , Luo Yu-Ming , Niu Dong-Dong , Guo Jian-Hua , Jiang Chun-Hao
Published: August 2022

Bacillus spp. are known for their ability to control plant diseases; however, the mechanism of disease control by Bacillus spp. is still unclear. Previously, bacterial organic acids have been implicated in the process of disease suppression. We extracted the total organic acid from Bacillus cereus AR156 culture filtrate and identified oxalic acid (OA) as the programmed cell death–inducing factor. OA strongly suppressed the lesion caused by Botrytis cinerea without significant antagonism against the fungus. Low concentration of OA produced by Bacillus spp. inhibited cell death caused by high concentrations of OA in a concentration- and time-dependent manner. Pretreatment with a low concentration of OA led to higher accumulation of active oxygen-scavenging enzymes in tomato leaves and provoked the expression of defense-related genes. The activation of gene expression relied on the jasmonic acid (JA) signaling pathway but not the salicylic acid (SA) pathway. The disease suppression capacity of OA was confirmed on wild-type tomato and its SA accumulation–deficient line, while the control effect was diminished in JA synthesis–deficient mutant, suggesting that the OA-triggered resistance relied on JA and ethylene (ET) signaling transduction. OA secretion ability was widely distributed among the tested Bacillus strains and the final environmental OA concentration was under strict regulation by a pH-sensitive degradation mechanism. This study provides the first systematic analysis on the role of low-concentration OA secreted and maintained by Bacillus spp. in suppression of gray mold disease and determines the dependence of OA-mediated resistance on the JA/ET signaling pathway.

[Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2022.
Curricula, Teaching Methods, and Success Metrics of Clinician–Scientist Training Programs: A Scoping Review
Authors: Li Queenie K.W. , Wollny Krista , Twilt Marinka , Walsh Catharine M. , Bright Katherine , Dimitropoulos Gina , Pires Linda , Pritchard Lesley , Samuel Susan , Tomfohr-Madsen Lianne
Published: August 2022

Purpose

To describe the literature on clinician–scientist training programs to inform the development of contemporary and inclusive training models.

Method

The authors conducted a scoping review, searching the PubMed/MEDLINE, CINAHL, and Embase databases from database inception until May 25, 2020. Studies presenting primary research that described and evaluated clinician–scientist training programs were identified for data abstraction. On the basis of deductive and inductive methods, information about program characteristics, curricula, teaching strategies, and success metrics was extracted. The extracted variables were analyzed using descriptive statistics.

Results

From the initial 7,544 citations retrieved and 4,974 unique abstracts screened, 81 studies were included. Of the 81 included studies, 65 (80.2%) were published between 2011 and 2020, 54 (66.7%) were conducted in the United States, and 64 (79.0%) described programs that provided broad clinician–scientist training. Few programs provided funding or protected research time or specifically addressed needs of trainees from underrepresented minority groups. Curricula emphasized research methods and knowledge dissemination, whereas patient-oriented research competencies were not described. Most programs incorporated aspects of mentorship and used multiple teaching strategies, such as direct and interactive instruction. Extrinsic metrics of success (e.g., research output) were dominant in reported program outcomes compared with markers of intrinsic success (e.g., career fulfillment).

Conclusions

Although programs are providing clinician–scientists with practical skills training, opportunities exist for curricular and pedagogic optimization that may better support this complex career path. Training programs for clinician–scientists can address contemporary issues of wellness and equity by reconsidering metrics of program success and evolving the core tenets of their education models to include equity, diversity, and inclusion principles and patient-oriented research competencies.
Barriers to Care for Nursing Home Residents With Substance Use Disorders: A Qualitative Study
Authors: Yang Meredith , Beiting Kimberly J. , Levine Stacie
Published: August 2022

Objectives

Over the past decade, the numbers of older adults with opioid and substance use disorders (OUD/SUD) have increased. As this population enters nursing homes (NHs) in increasing numbers, it is crucial to consider their capacity to manage issues related to OUD/SUD. This study aimed to examine current NH protocols for care coordination of residents with OUD/SUD as well as facility-related barriers to providing care to this vulnerable population within the NH.

Methods

Twenty-four semistructured interviews were conducted with NH staff including directors of nursing, administrators, nurses, and physicians in July 2020. Staff were recruited from 11 different post–acute care and long-term care facilities located in urban and suburban communities of Chicago. Interviews were conducted virtually (via teleconference platform or by telephone) and subsequently coded using ATLAS.ti 8 (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany) using constant comparative method.

Results

Qualitative analyses identified 3 themes around NH barriers to care for residents with SUD/OUD: (1) staff preparedness, (2) staff perceptions of addiction, and (3) overall lack of resources. Results revealed a strong need for the development of consistent policies, as well as standardized, educational interventions for NH staff that target SUD/OUD management in this vulnerable population.

Conclusions

The evaluation and impact of persons with SUD/OUD entering NHs are an important topic that requires further study. More resources and staff training are necessary to ensure that residents with SUD/OUD have access to appropriate care within these settings.
Developing a Theory of Norm-Criticism in Nursing Education
Authors: Nye Caitlin M. , Tengelin Ellinor , Somayaji Darryl
Published: August 2022

In this article, we explore the core concepts of norm-critical pedagogy developed in Sweden and only recently applied to nursing education praxis. These concepts, norms, power, and othering, are defined and demonstrated with exemplars from recent nursing education research. The theoretical model illustrates the ways in which these elements articulate in relationship to each other in nursing education praxis in ways that are dynamic, interlocking—like the gears of a clock—and resistant to interruption. We discuss the potential of a structurally oriented critical reflexivity—an equal and opposite force to the motion of the gears—to interrupt their motion.
Descriptive Epidemiology of Upper Extremity Septic Arthritis in Children—Review of a Retrospective Multicenter Database
Authors: Li Ying , Sanborn Ryan M. , Cook Danielle , Baldwin Keith D. , Beebe Allan C. , Denning Jaime R. , Goldstein Rachel Y. , Janicki Joseph A. , Johnson Megan E. , Truong Walter H. , Shore Benjamin J. ,   Children’s Orthopaedic Trauma and Infection Consortium for Evidence-Based Studies (CORTICES)
Published: August 2022

Background:

There is limited information on the presentation and management of upper extremity septic arthritis (UESA) in children. Our purpose was to report on the characteristics and short-term treatment outcomes of pediatric UESA from a multicenter database.

Methods:

Patients with UESA were identified from a multicenter retrospective musculoskeletal infection database. Demographics, laboratory tests, culture results, number of surgeries, and complications were collected.

Results:

Of 684 patients with septic arthritis (SA), 68 (10%) patients had UESA. Septic arthritis was most common in the elbow (53%), followed by the shoulder (41%) and wrist (4%). The median age at admission was 1.7 years [interquartile range(IQR, 0.8-8.0 y)] and 66% of the cohort was male. Blood cultures were collected in 65 (96%) patients with 23 (34%) positive results. Joint aspirate and/or tissue cultures were obtained in 66 (97%) patients with 49 (72%) positive results. Methicillin-sensitive Staphylococcus aureus (MSSA) was the most common causative organism overall, but Streptococcus was the most common pathogen in the shoulder. Sixty-six (97%) patients underwent irrigation and debridement, with 5 (7%) patients requiring 2 surgeries and 1 patient (1%) requiring 3 surgeries. The median length of stay was 4.9 days (IQR, 4.0-6.3 d). Thirty-one (46%) children had adjacent musculoskeletal infections and/or persistent bacteremia. No patients experienced venous thromboembolism, and 4 patients with associated osteomyelitis experienced a musculoskeletal complication (3 avascular necrosis, 1 pathologic fracture). One child had re-admission and 3 children with associated osteomyelitis had a recurrence of UESA. Comparison between elbow and shoulder locations showed that children with septic arthritis of the shoulder were younger (4.6 vs. 1.0 y, P=0.001), and there was a difference in minimum platelet count (280 vs. 358 ×109 cells/L, P=0.02).

Conclusions:

UESA comprises 10% of cases of septic arthritis in children. The elbow is the most common location. Shoulder septic arthritis affects younger children. MSSA is the most common causative organism in UESA, but Streptococcus is common in shoulder septic arthritis. Irrigation and debridement result in excellent short-term outcomes with a low complication rate. Re-admissions and repeat surgical interventions are rare.

Level of Evidence:

Level IV, prognostic.
The Symptoms and Information Needs of Chinese Adults After Stem Cell Transplantation
Authors: Chen Mei-Hui , Teng Chieh-Lin Jerry , Huang Hui-Mei , Chao Yann-Fen C.
Published: August 2022

Background:

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be accompanied by physical and emotional adversities for adult patients that may lower their quality of life during the first year following the transplant.

Objective:

To identify the physical and emotional distress after allo-HSCT, health information needs, and quality of life of adult allo-HSCT patients at key points during the first year following the transplantation.

Methods:

This cross-sectional study design included 65 patients post allo-HSCT treatment at 1 of 4 time periods: 30 days, 31–100 days, and 101–365 days. We assessed their distressing symptoms, health information needs, and quality of life.

Results:

We found that participants in each time period had different symptoms and information needs. Five symptoms differed significantly by time period: oral mucositis, diarrhea, nausea, hair loss, and fever (P < .05). Health information needs related to activities, drug information, blood reports, and preventive measures, dietary preventive measures, active preventive measures, symptom management, and infection control methods also differed significantly by time period.

Conclusions:

Adult post allo-HSCT patients experience varying physical and mental distress in different time periods and with varying quality of life during the first year following the transplant. The health information which the patients reported lacking also differed by time period.

Implications for Practice:

Healthcare providers must provide sufficient information to allo-HSCT transplant patients according to their needs at each time period and take measures to alleviate the symptoms related to the allo-HSCT to improve patients’ quality of life.

What is Foundational:

Two new promising measures, the Symptom Distress Severity Questionnaire and the Health Information Needs Questionnaire, were assessed in this study and found to have high internal consistency and concurrent validity with an established symptom measure.
Caregiver Burden of Cancer Patients Related to Cognitive Decline at End of Life
Authors: Takao Ayumi , Yamamoto Sena , Arao Harue
Published: August 2022

Background:

Cognitive decline in cancer patients at the end of life makes it difficult for caregivers to manage symptoms and decide on cancer care.

Objective:

To define caregiver burden in relation to cancer patients with cognitive decline at the end of life.

Methods:

We use Walker and Avant’s eight-step concept analysis. We searched the MEDLINE, CINAHL, and Web of Science databases for relevant articles published between 2000 and 2020.

Results:

Caregiver burden for comorbid cancer and cognitive decline patients is defined as the pressure experienced by families in a multidimensional way due to the two deteriorating diseases in their process of facing the loss even before the deaths of patients and fulfilling their responsibilities as a family without knowing the patients’ own intentions. The antecedents included physical needs of caregiving, the cognitive decline of the patient, and whether the patient was dying. The consequences included caregivers’ physical and psychological health deterioration, decreasing caregivers’ coping abilities, and deterioration in the quality of death.

Conclusions:

This concept analysis indicated that the caregiver burden population should consider the characteristics of cancer and cognitive decline in interventions.

Implications for Practice:

Nurses should assess patients’ physical, psychosocial, and spiritual needs from various perspectives in advance to coordinate holistic care and prevent complications. Sharing the patient and caregiver’s history is important when discussing the patient’s wishes with the caregiver.

Foundational:

Caregivers in this population experience heavy responsibilities, multidimensional pressures, and the loss of patients before death. They are often required to be proxy decision-makers.
Toward Transformative Engagement: Ethical and Effective Clinical-Research Partnerships in Cancer Care Nursing
Authors: Whitney Clare , Canale Elise , Zinck Lindsey
Published: August 2022

Background:

Clinical nurses have the potential to conduct impactful practice-focused research, enhancing institutional research cultures and improving patient outcomes. However, collaboration between clinical nurses and academic nurse scientists can be challenging and resource intensive.

Objective:

Describe how transformative clinical-research partnership facilitates achieving mutual goals for clinical nurses and academic nurse scientists.

Methods:

The Virtual Supportive Cancer Care Research (ViSuCaRe) Study, a multisite, mixed-method study, was conducted through a clinical-research partnership to explore the experience of patients and clinicians engaging in supportive cancer care via telehealth during the COVID-19 pandemic.

Results:

We describe research and quality improvement products and identify how the ViSuCaRe Study addressed three common challenges to clinical-research partnerships. (1) Study conception, construction, and development prioritized frontline clinical staff involvement; (2) Data collection and analysis engaged clinical partners in recruitment, interviewing, data management, coding, and theory-building; (3) Subsequent analyses, products, and dissemination efforts emerged from evolving needs of clinical partners and shifted in accordance with their arising priorities.

Conclusions:

Using an approach to collaboration centered on transformative engagement offers clinical nurses and academic nurse scientists.

Implications for Practice:

Frontline clinical staff should have consistent and meaningful roles in developmental, analytic, and dissemination-directing processes. Supporting clinical nurses’ engagement in research activities will enable them to identify and address problems that impact practice, enhance research cultures, and promote evidence-based practice.

Foundational:

Using a model of transformative engagement, rooted in community engagement, allows nurses to carry out collaborative practice-focused research. Clinical-academic partnerships offer an economical approach to enhancing clinical nurses’ research capacities.
Self-reported Professional Competence Among Swedish Contact Nurses in Cancer Care: A Cross-sectional Study
Authors: Bjuresäter Kaisa , Olsson Cecilia , Larsson Maria , Nilsson Jan
Published: August 2022

Background:

Since 2011, patients in Swedish cancer care have been offered a contact nurse (CN). The CN role is to improve patient participation, care continuity, and provide information and manage patients’ symptoms and needs across the whole continuum of the cancer pathway. A competence profile for the CN role is yet to be developed, and it is important to assess CNs’ self-reported competence to assure that they are well equipped for the role.

Objectives:

To assess self-reported professional competence among contact nurses working in Swedish cancer care and relate the findings to education level and clinical experience.

Methods:

The Nurse Professional Competence scale short form (35 items) was used to assess the nurses’ professional competence. Data were collected through a web-based survey in 2017 in 2 regional cancer centers in Sweden.

Results:

One hundred eight CNs participated in the study and reported highest scores in “value-based nursing care” and lowest scores in “development, leadership, and organization of nursing care.” Higher age, extended clinical work experience, and academic degree were significantly associated with higher competence.

Conclusions:

CNs with extensive work experience and CNs with an academic degree reported higher scores concerning their generic competence. There is a need in future studies to assess CNs’ specific competence in cancer care.

Implications for Practice:

There is room for improvement in the competence development of CNs, primarily in the areas of leadership and organization of nursing care.

What is Foundational:

CNs’ competence regarding leadership and organization should be improved, preferably as part of academic education.
Aquablation in men with benign prostate hyperplasia: A systematic review and meta-analysis
Authors: Chen David C. , Qu Liang , Webb Howard , Qin Kirby , Chislett Bodie , Xue Alan , Khaleel Sari , De Jesus Escano Manuel , Chung Eric , Adam Ahmed , Bolton Damien , Perera Marlon
Published: August 2022

Objective

The aim of the study is to investigate improvements in lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH) treated with prostatic Aquablation.

Materials and methods

We performed a literature search of clinical trials using the MEDLINE, Embase, and Cochrane Library databases and retrieved published works on Aquablation for the treatment of BPH up to August 2021. Unpublished works, case reports, conference proceedings, editorial comments, and letters were excluded. Risk of bias was assessed using the ROBINS-I tool. Raw means and mean differences were meta-analyzed to produce summary estimates for pre-versus post-International Prostate Symptom Scores, maximum flow rate, and male sexual health questionnaire value changes. An inverse-variance weighted random effects model was used.

Results

Seven studies were included in this review (n = 551 patients) that evaluated various urological parameters. At 3 months, the International Prostate Symptom Scores raw mean difference from baseline was −16.475 (95% confidence interval [CI], −15.264 to −17.686; p < 0.001), with improvements sustained for 12 months. Similarly, maximum flow rate improved by +1.96 (95% CI, 10.015 to 11.878; p < 0.001) from pre to post at 3 months postoperatively. In addition, the male sexual health questionnaire change pooled effect size was −0.55 (95% CI, −1.621 to 0.531; p = 0.321) from preintervention to postintervention at 3 months. Meta-analyses of some outcomes showed large statistical heterogeneity or evidence of publication bias.

Conclusions

Aquablation seems to improve lower urinary tract symptoms in men with BPH while providing relatively preserved sexual function. Further research is required to confirm these preliminary results.
An independent practice validation of the Prostate Imaging Reporting and Data System version 2 scoring system and the introduction of PDP (prostate-specific antigen density × PI-RADSv2) score to assist with further risk assessment
Authors: Patel Parth U. , Bock David , Hettinger Christian A.
Published: August 2022

Objectives

To provide concise information to clinicians on how to better interpret multiparametric magnetic resonance imaging for prostate cancer risk stratification.

Materials and methods

We analyzed 2 separate cohorts. For patients receiving a Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) score of 1 or 2, we reviewed the charts of 226 patients who underwent multiparametric magnetic resonance imaging of the prostate ordered from 2015 to 2017 to determine who developed clinically significant prostate cancer (csPCa) by August 27, 2020. For patients receiving PI-RADSv2 a score of 3, 4, or 5, we reviewed the results of 733 fusion biopsies on solitary lesions. Statistical analysis was used to further determine risk factors for csPCa.

Results

Ten percent of men with PI-RADSv2 a score of 1 eventually developed csPCa. Seven percent with a score of 2 were eventually diagnosed with csPCa. Only 1 of 226 with a score of 1 or 2 developed metastasis. For PI-RADSv2 scores of 3, 4, and 5, csPCa was detected in 16%, 45%, and 67% of fusion biopsies. Peripheral zone (PZ) PI-RADSv2 score of 4 or 5 and prostate-specific antigen density (PSA-D) were significant predictors of csPCa on multivariable analysis. Using a PSA-D × PI-RADSv2 score of ≤0.39, we identified 38% of men with a PI-RADSv2 score of 3 in the PZ or 3, 4, or 5 in the transition zone who could have avoided a benign biopsy.

Conclusions

The vast majority of patients with PI-RADSv2 scores 1 and 2 can be safely monitored with close surveillance. Lesions with PI-RADSv2 scores of 4 and 5 in the PZ should be biopsied. Peripheral zone lesions with a PI-RADSv2 score of 3 and transition zone lesions with 3, 4, or 5 can be risk-stratified using the PSA-D × PI-RADSv2 score to determine who may safely avoid a biopsy and who should proceed to fusion biopsy.
Extracorporeal Membrane Oxygenation During Pregnancy
Authors: Pacheco Luis D. , Shamshirsaz Amir A.
Published: August 2022

In the last 2 decades, the use of venovenous (VV) and venoarterial (VA) extracorporeal membrane oxygenation (ECMO) during pregnancy and the postpartum period has increased, mirroring the increased utilization in nonpregnant individuals worldwide. VV ECMO provides respiratory support for patients with acute respiratory distress syndrome (ARDS) who fail conventional mechanical ventilation. With the COVID-19 pandemic, the use of VV ECMO has increased dramatically and data during pregnancy and the postpartum period are overall reassuring. In contrast, VA ECMO provides both respiratory and cardiovascular support. Data on the use of VA ECMO during pregnancy are extremely limited.
Achieving Equity in Postpartum Contraception Access
Authors: McAllister Arden , Christensen Theresa , Dixit Eshani , Chesnokova Arina , Sonalkar Sarita
Published: August 2022

Equitable access to contraception and contraceptive education has the potential to mitigate health disparities related to unintended pregnancy. Pregnancy and the postpartum window frequently offer reduced insurance barriers to healthcare, increased interaction with healthcare systems and family planning providers, and an opportune time for many individuals to receive contraception; however, there are additional considerations in method type for postpartum individuals, and contraceptive counseling must be thoughtfully conducted to avoid coercion and promote shared decision-making. This commentary reviews method-specific considerations and suggests priorities for achieving equity in postpartum contraceptive access.