bluuebunny/crossref_metadata_2025 huggingface dataset:
Isotope Mixing
Authors: Cotrufo M. Francesca , Pressler Yamina
Published: September 2023

“Isotope Mixing” reviews principles and applications of stable isotope mixing models in ecology. The chapter describes how ecologists developed stable isotope mixing models to study source partitioning by applying the principle of mass balance. Equations for the mathematical solution of two- and three-pool mixing models, using one and two isotopes respectively, are presented. The chapter expands upon approaches for accounting for fractionation and elemental concentration in isotope mixing models. The chapter explores the Keeling plot method for quantifying the isotopic composition of an unknown source. Approaches for quantifying contributions from multiple sources and evaluating uncertainty in isotope mixing models, including Bayesian statistics, are introduced.
Heavy Isotope Enrichments
Authors: Cotrufo M. Francesca , Pressler Yamina
Published: September 2023

“Heavy Isotope Enrichments” reviews concepts for developing and interpreting heavy isotope labeling studies in ecology. The chapter compares continuous- and pulse-labeling approaches for the 13C labeling of plant material. Methods for the application of isotope-labeled substrates and their use in stable isotope probing of biological markers are presented. Calculations of the heavy isotope excess and the quantification of the recovery of heavy isotope additions in isotope tracing studies are provided. Principles and equations for the application of the isotope dilution method are illustrated, and its limitations are discussed. Examples of applications for carbon, nitrogen, and water stable isotopes are presented.
Hindu Diaspora and Hinduisms in Africa, with Special Focus on South Africa
Authors: Penumala Pratap Kumar
Published: September 2023

The chapter deals with the range of Hindu practices and traditions and histories found in Africa, with emphasis on South Africa. Although, technically, Mauritius and La Réunion come under East Africa, they are treated separately at the beginning of the chapter, and South Africa, East Africa, and West Africa are dealt with in that order because Mauritius, La Réunion, and South Africa share a common indenture history. While Hinduism in Mauritius is underpinned by its creole culture, La Réunion Hinduism is closely tied with Roman Catholicism. A marked tension between non-Brahmanical Hinduism and the various neo-Hindu organizations is found in South Africa. It is safe to say that the East African Hinduism is primarily situated within the Gujarati community’s migration to that region; other contemporary movements and traditions gradually made their presence felt. Quite uniquely, however, Ghananian Hinduism begins with indigenous efforts, although later on those efforts were joined by other organizations. As such, Hinduism in Africa shares a variety of histories, migrations patterns, and socio-economic conditions as well as political struggles. Hinduism shows resilience by its ability to adapt to these varied conditions.
Śākta (Goddess) Worship in the Hindu Diasporas
Authors: Pintchman Tracy
Published: September 2023

This chapter explores Hindu goddess traditions that migrating Hindus perpetuate outside of India. The chapter is divided into three sections. The first section of the chapter explores Hindu goddess temples in diaspora; the second section explores diaspora Hindus’ public and domestic rituals honouring the Goddess; and the last section explores diaspora Hindus’ experiences of goddess possession and female gurus whom devotees consider to be living forms of the Goddess. The chapter examines the many ways that Hindu goddess devotees both reproduce and revise Indian Hindu goddess traditions as they move around the globe and adapt their traditions of goddess reverence to their new homelands.
The Source of Logical Necessity
Authors: Leech Jessica
Published: September 2023

This chapter presents an account of the source of logical necessity. An account according to which logical laws, and hence logical modality, have their source in thought, more particularly, in constitutive norms for thought, is introduced and defended. Constitutive norms for thought, it is explained, are norms evaluability in light of which is constitutive of thought. A test is introduced which, it is contended, all accounts of logical modality should pass. In short, any account of logical necessity must account for two important features: logical necessity is factive (if it is logically necessary that p, then p ); and some logical necessities are immune to rational doubt. It is argued that the proposed account of the source of logical modality passes the test, and that some rival accounts fail.
What Is Metaphysical Necessity?
Authors: Leech Jessica
Published: September 2023

It is argued that the conception of objective modality isolated and motivated in Chapter 5 should be understood as metaphysical modality. First, the chapter distinguishes between questions concerning the target notion of metaphysical necessity, and questions concerning what metaphysical account we should give of the target notion. It is argued that the target notion of metaphysical necessity is the strictest real necessity. It is further argued that the kind of objective necessity introduced in Chapter 5 fits the bill for providing an account of the strictest real necessity. An appendix defends the notion of metaphysical necessity against several recent attacks.
Relative and Absolute Necessity
Authors: Leech Jessica
Published: September 2023

This chapter explores the claim that metaphysical necessity is a kind of relative necessity. The notions of `absolute necessity' and `relative necessity' are clarified and made more precise. The chapter addresses the issue of where to draw the line for absolute modalities, and why absolute modality should not stop short with metaphysical modality. The chapter then considers some arguments in favour of treating metaphysical modality and other alethic modalities as relative, drawing on linguistic considerations as well as more general considerations of similarity and difference between different kinds of modality. It is concluded that logical necessity is absolute necessity, and that metaphysical necessity is logical necessity relativized to conditions on objective thought.
The Paradox of Intervention
Authors: de Boer David
Published: September 2023

In 1655, an army under Savoyard command perpetrated a massacre among the Reformed Waldensians in Piedmont. Following the European echo of the killings from the refugees who first wrote down their experiences to the printing presses in the Dutch Republic, this chapter explores how victims of persecution could assume political agency and raise international support through print. It reveals that confessional minorities seeking foreign support stepped into a complex communicative landscape through which they had to steer carefully. Investigating how they strategically deployed different argumentative strategies, this chapter tries to explain and nuance the recent historiographical observation that Protestant polemic shifted “from martyrology to humanitarianism” in the mid-seventeenth century. It will be argued that rather than seeing historical turning points in polemic, advocates employed both confessional and universal argumentative strategies, depending on the audiences they hoped and sometimes feared to reach.
Covering a Refugee Crisis
Authors: de Boer David
Published: September 2023

The massive refugee crisis that followed the 1685 prohibition of Protestantism in France led to an outpouring of printed opinion in the Dutch Republic about the fate of the Huguenots. This chapter challenges the assumption that these print media were mainly characterized by a militant confessional outlook on domestic and international politics. It argues that France’s violent policy of religious unification incited an unprecedently diverse transnational debate as an age-old question suddenly became an urgent matter: how do we deal with religious differences in Europe and how does it affect our confession, country, and city? Among many observers, there was an urgent sense that press coverage was crucial to confront the humanitarian disaster that unfolded in France, the consequences of which were felt throughout Europe. While some opinion makers reacted by entrenching themselves on one side of the confessional divide, others saw the acute need to bridge it and establish interconfessional dialogues about the foundation of social and political order.
Between Eschatology and Enlightenment
Authors: de Boer David
Published: September 2023

Relatively minor instances of religious persecution could sometimes turn into huge media sensations. This chapter reconstructs the anatomy of this process by exploring the coverage of the execution of ten Lutheran citizens in the Polish-Prussian city of Toruń in 1724. It explores the public manner in which Europe’s Protestant powers intervened in the so-called “Bloodbath of Toruń,” elevating the “reasonable” public to moral arbiters in the conflict. By doing so, intervening rulers set a precedent for heated international discussion about the nature of the conflict and the desired international response. The chapter argues that printed expressions of transnational solidarity with victims of persecution became ever more prevalent because it was a major theme in both confessional and Enlightenment perceptions of European politics. To evaluate the relative importance of these interpretations, the chapter concludes by comparing international responses to the Tumult of Toruń with those to the expulsion of the Jews from Prague in 1744.
Themes and Ideas
Authors: Windeatt Barry
Published: September 2023

This chapter first explores how the poem constitutes a form of debate about the nature and value of love, before analysing the poem’s concerns with love within time and with love and freedom, concluding with sections on the poem’s principal figures and its problematic ending. After an introductory section on source awareness in Troilus, this chapter discusses how the poem includes debate and deliberation about the experience of love, and surveys the poem’s representations of how love can be understood as service, as quasi-religious devotion, and as illness, along with the role of compassion and of commitments to secrecy, honour and fidelity. A section is devoted to the poem’s presentation of subjectivity in its protagonists, followed by analyses of the personalities of Troilus, Criseyde, Pandarus and Diomede. A final section discusses the challenges to interpretation posed by how the poem ends.
An uncertain world!
Authors: Zubairy M. Suhail
Published: September 2023

One of the foundational principles of quantum mechanics is Heisenberg’s uncertainty relation. According to this relation, no one can measure both the position of a particle and how fast it is moving simultaneously no matter how precise the measuring instruments. Heisenberg’s uncertainty relation and the associated Bohr’s principle of complementarity are explained using simple examples. The idea that measurement disturbs the system is a source of the uncertainty. The philosophical question whether the uncertainty represents only our inability to measure the properties precisely or it has much deeper consequences related to the question of reality is also discussed.
Wave–particle duality
Authors: Zubairy M. Suhail
Published: September 2023

Young’s double-slit experiment played a crucial role in establishing the wave nature of light. In this chapter, the shocking result that incident electrons yield a similar interference pattern as that formed by light waves is described. It is shown that the only way the experimental results could be explained is via a wavefunction description of electrons. It is also shown that the interference fringes disappear if the which-path information becomes available. This is the essence of wave–particle duality. The first of the Einstein–Bohr debates on wave–particle duality and Bohr’s principle of complementarity in the double-slit experiment are also discussed. The counterintuitive notions of delayed choice and quantum eraser effects showing how the availability or erasure of information generated in the future can affect how the data in the present can be interpreted are presented. Quantum interference is responsible for novel phenomena like interaction-free measurement and counterfactual communication.
Einstein’s special theory of relativity
Authors: Zubairy M. Suhail
Published: September 2023

Einstein’s special theory of relativity is presented along with its mind-boggling consequences. These consequences include loss of simultaneity, time dilation, and length contraction, each of which are discussed. The role of the Michelson–Morley experiment in the formulation of the special theory of relativity is also discussed. The ladder paradox and the twin paradox and their resolutions are presented. An important consequence of the theory of relativity is that mass and energy are interconvertible. It is also shown that the maximum allowed speed is the speed of light. If the speed of light is exceeded then causality can be violated.
Conclusion
Authors: Scholtes Julian
Published: September 2023

This concluding chapter draws together the insights of the book and reviews the three key dimensions of the abuse of constitutional identity highlighted throughout. Particular attention is paid to the ways in which the generative, substantive, and relational dimensions of constitutional identity abuse overlap and interact with one another. It outlines some of the limitations of the book’s scope of inquiry and points to questions that were left unaddressed. The conclusion furthermore offers some thoughts on how the insights developed in this book may be useful beyond the EU context and how wider theoretical questions about constitutional identity may spring from it.
Unorthodox Conceptions of the Cartesian Mind, Inside and Outside the University of Leiden
Authors: Jaworzyn Michael
Published: September 2023

This chapter evaluates how the standard views of the Cartesian mind were revised and transformed in Arnold Geulincx’s own philosophical tradition. It addresses the developments within Geulincx’s works over his career, and in the works of two thinkers who wrote in his wake: Cornelis Bontekoe and Arnold Houbraken. When he moved to the University of Leiden in 1659, Geulincx’s teaching had to remain within the ‘bounds of the Aristotelian philosophy’ at first. It was presumably his apparent Cartesianism that worried the authorities. At some point in the course of his career, Geulincx held some apparently strange views of the mind that went far beyond what was standard (or acceptable) among Cartesians. Most strikingly, he refers to the mind as a ‘mode’ of the divine mind, a claim which many would have associated with Spinozism and atheism. Meanwhile, in his posthumous 1688 Metaphysica, Bontekoe denies the mind’s ability to change itself. Bontekoe thinks that each thought, each mode of thinking, remains as it is — the mind remains as it is — until something else changes it. For Houbraken, unlike the more unconventional strand of Geulincx’s work, the mind is a thinking thing in the ordinary Cartesian sense, and unlike for Bontekoe, it seems that it is capable of bringing things about within itself.
University Divinity and Intellectual Innovation in Eighteenth-Century Scotland
Authors: Raffe Alasdair
Published: September 2023

This chapter examines intellectual innovation in eighteenth-century Scotland which, as it shows, was strongly influenced by the country’s institutions. It relates this development with, particular reference to John Simson (1667–1740), professor of divinity at the University of Glasgow. Simson was twice prosecuted in the church courts for his alleged errors. As the chapter shows, however much that Scottish university divinity was transformed in the first half of the eighteenth century, its remoulding was not the result of any open assault on received doctrines, outright approval of heterodoxies, or enlightened campaign for free speech. Rather, the silences of divinity professors undermined the systematic quality of Reformed orthodoxy, producing a diluted Christianity. This simplified brand of Protestantism, the chapter concludes, coexisted with evolving forms of evangelical orthodoxy. John Simson and his trials, the chapter argues, may not have heralded the Scottish Enlightenment, but they contributed to the intellectual pluralisation of Scottish presbyterian culture.
“This World-Wide Need”
Authors: Jahanbani Sheyda F.A.
Published: September 2023

This chapter explores the global thought of John Collier and a transnational community of experts he brought together to address the conditions of “dependent” peoples. A Progressive Era social reformer, Collier encountered Native American poverty firsthand in the 1920s and became a lifelong advocate for indigenous people. As Franklin Roosevelt’s Bureau of Indian Affairs Commissioner, Collier drew on a vast network of social science experts in the United States and Mexico to reform policies toward native people. In 1941, as the US entered World War II, Collier established the Inter-American Indian Institute, from which he and his allies in Mexico collaborated to address the poverty of indigenous peoples throughout the Western Hemisphere. Identifying Indian poverty as a consequence of colonization, Collier used his position to create both demand and supply for new ideas about poverty in the emerging context of decolonization.
“Not Modern Men”
Authors: Jahanbani Sheyda F.A.
Published: September 2023

This chapter explores the creation of an explicitly cross-cultural theory of poverty, one that updated distinctions between rich and poor for an age of cultural relativism and global development. It revisits the life and work of anthropologist Oscar Lewis and his controversial “culture of poverty” theory. From Lewis’s work for John Collier’s Indian Personality Project in Mexico to his fieldwork in rural urban slums in Mexico, Puerto Rico, India, and the United States, this chapter reinterprets Lewis as a major theorist of “underdevelopment,” arguing that his culture of poverty thesis became one especially trenchant way of thinking about “world poverty” for policymakers in the 1960s.
Identifying child maltreatment during virtual medical appointments through the COVID-19 pandemic
Authors: Lim-Reinders Stephanie , Ward Michelle G K , Malic Claudia , Keely Kathryn , Kang Kristopher , Jain Nita , Zwicker Kelley
Published: September 2023

Background

Throughout the COVID-19 pandemic there has been a documented decline in reports to child protective services, despite an increased incidence of child maltreatment. This is concerning for increasing missed cases. This study aims to examine if and how Canadian paediatricians are identifying maltreatment in virtual medical appointments.

Methods

A survey was sent through the Canadian Paediatric Surveillance Program (CPSP) to 2770 practicing general and subspecialty paediatricians. Data was collected November 2021 to January 2022.

Results

With a 34% (928/2770) response rate, 704 surveys were eligible for analysis. At least one case of child maltreatment was reported by 11% (78/700) of respondents following a virtual appointment. The number of cases reported was associated with years in medical practice (P = 0.026) but not with the volume (P = 0.735) or prior experience (P = 0.127) with virtual care, or perceived difficulty in identifying cases virtually (Cramer’s V = 0.096). The most common factors triggering concern were the presence of social stressors, or a clear disclosure. The virtual physical exam was not contributory. Nearly one quarter (24%, 34/143) required a subsequent in-person appointment prior to reporting the case and 32% (207/648) reported concerns that a case had been identified late, or missed, following a virtual appointment. Some commented that clear harm resulted.

Conclusions

Many barriers to detecting child maltreatment were identified by paediatricians who used virtual care. This survey reveals that virtual care may be an important factor in missed cases of child maltreatment and may present challenges to timely identification.
Did Gender Egalitarianism Weaken Religiosity in Baby Boom Women? A Developmental-Historical Approach
Authors: Silverstein Merril , Hwang Woosang , Kim Jeung Hyun , Brown Maria T
Published: September 2023

This investigation used long-term longitudinal survey data from baby boomer women to identify whether strengthening gender role egalitarianism in early adulthood predicted declines in religious service attendance and religious intensity in later life. The aging of this cohort coincided with dramatic societal shifts in gender values and religiosity. The data were derived from 350 women participating in the Longitudinal Study of Generations, a study originally fielded in 1971 of families living in Southern California. Respondents were initially assessed in their late teens and early 20s and followed up to their early-to-mid 60s. Using growth curve modeling, we linked the change in egalitarian gender attitudes from 1971 to 1988 to a change in religiosity from 1994 to 2016. Women who became more egalitarian in their gender attitudes experienced sharper declines in religious intensity, but not in religious attendance in the period studied. Controlling for life-course transitions did not alter these results. The findings are discussed in terms of the connection between two asynchronous social changes occurring over the lives of women in a uniquely positioned birth cohort.
Mechanisms of Breast Cancer Stem Cell Specification and Self-Renewal Mediated by Hypoxia-Inducible Factor 1
Authors: Semenza Gregg L
Published: September 2023

Many advanced human cancers contain regions of intratumoral hypoxia, with O2 gradients extending to anoxia. Hypoxia-inducible factors (HIFs) are activated in hypoxic cancer cells and drive metabolic reprogramming, vascularization, invasion, and metastasis. Hypoxia induces breast cancer stem cell (BCSC) specification by inducing the expression and/or activity of the pluripotency factors KLF4, NANOG, OCT4, and SOX2. Recent studies have identified HIF-1-dependent expression of PLXNB3, NARF, and TERT in hypoxic breast cancer cells. PLXNB3 binds to and activates the MET receptor tyrosine kinase, leading to activation of the SRC non-receptor tyrosine kinase and subsequently focal adhesion kinase, which promotes cancer cell migration and invasion. PLXNB3-MET-SRC signaling also activates STAT3, a transcription factor that mediates increased NANOG gene expression. Hypoxia-induced NARF binds to OCT4 and serves as a coactivator by stabilizing OCT4 binding to the KLF4, NANOG, and SOX2 genes and by stabilizing the interaction of OCT4 with KDM6A, a histone demethylase that erases repressive trimethylation of histone H3 at lysine 27, thereby increasing KLF4, NANOG, and SOX2 gene expression. In addition to increasing pluripotency factor expression by these mechanisms, HIF-1 directly activates expression of the TERT gene encoding telomerase, the enzyme required for maintenance of telomeres, which is required for the unlimited self-renewal of BCSCs. HIF-1 binds to the TERT gene and recruits NANOG, which serves as a coactivator by promoting the subsequent recruitment of USP9X, a deubiquitinase that inhibits HIF-1α degradation, and p300, a histone acetyltransferase that mediates acetylation of H3K27, which is required for transcriptional activation.
Effects of simulated climate change conditions of increased temperature and [CO2] on the early growth and physiology of the tropical tree crop, Theobroma cacao L.
Authors: Mateus-Rodríguez Julián Fernando , Lahive Fiona , Hadley Paul , Daymond Andrew J
Published: September 2023

Despite multiple studies of the impact of climate change on temperate tree species, experiments on tropical and economically important tree crops, such as cacao (Theobroma cacao L.), are still limited. Here, we investigated the combined effects of increased temperature and atmospheric carbon dioxide concentration ([CO2]) on the growth, photosynthesis and development of juvenile plants of two contrasting cacao genotypes: SCA 6 and PA 107. The factorial growth chamber experiment combined two [CO2] treatments (410 and 700 p.p.m.) and three day/night temperature regimes (control: 31/22 °C, control + 2.5 °C: 33.5/24.5 °C and control + 5.0 °C: 36/27 °C) at a constant vapour pressure deficit (VPD) of 0.9 kPa. At elevated [CO2], the final dry weight and the total and individual leaf areas increased in both genotypes, while the duration for individual leaf expansion declined in PA 107. For both genotypes, elevated [CO2] also improved light-saturated net photosynthesis (Pn) and intrinsic water-use efficiency (iWUE), whereas leaf transpiration (E) and stomatal conductance (gs) decreased. Under a constant low VPD, increasing temperatures above 31/22 °C enhanced the rates of Pn, E and gs in both genotypes, suggesting that photosynthesis responds positively to higher temperatures than previously reported for cacao. However, dry weight and the total and individual leaf areas declined with increases in temperature, which was more evident in SCA 6 than PA 107, suggesting the latter genotype was more tolerant to elevated temperature. Our results suggest that the combined effect of elevated [CO2] and temperature is likely to improve the early growth of high temperature-tolerant genotypes, while elevated [CO2] appeared to ameliorate the negative effects of increased temperatures on growth parameters of more sensitive material. The evident genotypic variation observed in this study demonstrates the scope to select and breed cacao varieties capable of adapting to future climate change scenarios.
Multiple introductions and country-wide spread of DENV-2 genotype II (Cosmopolitan) in Brazil
Authors: Gräf Tiago , Ferreira Caroline Do Nascimento , de Lima Gustavo Barbosa , de Lima Raul Emídio , Machado Lais Ceschini , Campos Tulio de Lima , Schemberger Michelle Orane , Faoro Helisson , Paiva Marcelo Henrique Santos , Bezerra Matheus Filgueira , Nascimento Valdinete , Souza Victor , Nascimento Fernanda , Mejía Matilde , Silva Dejanane , de Oliveira Yasmin Silva , Gonçalves Luciana , Ramos Tatyana Costa Amorim , de Castro Daniel Barros , Arcanjo Ana Ruth , Dantas Herton Augusto Pinheiro , Presibella Mayra Marinho , Fernandes Sandra Bianchini , Gregianini Tatiana Schaffer , Paz E Silva Keilla Maria , Sacchi Claudio Tavares , Cruz Ana Cecília Ribeiro , Duarte dos Santos Claudia Nunes , Bispo de Filippis Ana Maria , Bello Gonzalo , Wallau Gabriel Luz , Salvato Richard Steiner , Naveca Felipe
Published: September 2023

Dengue virus serotype 2, genotype Cosmopolitan (DENV-2-GII), is one of the most widespread DENV strains globally. In the USA, DENV-2 epidemics have been dominated by DENV-2 genotype Asian-American (DENV-2-GIII), and the first cases of DENV-2-GII were only described in 2019, in Peru, and in 2021 in Brazil. To gain new information about the circulation of DENV-2-GII in Brazil, we sequenced 237 DENV-2 confirmed cases sampled between March 2021 and March 2023 and revealed that DENV-2-GII is already present in all geographic regions of Brazil. The phylogeographic analysis inferred that DENV-2-GII was introduced at least four times in Brazil, between May 2020 and August 2022, generating multiple clades that spread throughout the country with different success. Despite multiple introductions of DENV-2-GII, analysis of the country-wide laboratory surveillance data showed that the Brazilian dengue epidemic in 2022 was dominated by DENV-1 in most states. We hypothesize that massive circulation of DENV-2-GIII in previous years in Brazil might have created a population immune barrier against symptomatic homotypic reinfections by DENV-2-GII, leading to sustained cryptic circulation in asymptomatic cases and localized outbreaks of this new genotype. In summary, our study stresses the importance of arboviral genomic surveillance to close monitoring and better understanding the potential impact of DENV-2-GII in the coming years.
New sauropod dinosaur from the Lower Cretaceous of Morella (Spain) provides new insights on the evolutionary history of Iberian somphospondylan titanosauriforms
Authors: Mocho Pedro , Escaso Fernando , Gasulla José M , Galobart Àngel , Poza Begoña , Santos-Cubedo Andrés , Sanz José L , Ortega Francisco
Published: September 2023

A new somphospondylan titanosauriform from the Lower Cretaceous of Spain is described from the remains found at the Sant Antoni de la Vespa site (upper Barremian Arcillas de Morella Formation) located in Morella. Garumbatitan morellensis gen. et sp. nov. is diagnosed by 11 autapomorphies and eight local autapomorphies; and our phylogenetic analyses suggest that Garumbatitan morellensis might correspond to an early-branching somphospondylan. The presence of several somphospondylan traits in Garumbatitan morellensis supports the somphospondylan hypothesis. The phylogenetic distribution of some titanosauriform and somphospondylan novelties in the femur (markedly developed lateral bulge, high shaft eccentricity, linea intermuscularis cranialis, and trochanteric shelf) is discussed. The tarsus and pes of Garumbatitan morellensis are distinctive, being characterized by the loss of the calcaneum, relative slenderness of the metatarsals II, III, and IV when compared to the retracted metatarsals I and V, three pedal phalanges in digit IV, and reduced ungual III. The sauropod fauna of the Iberian Peninsula during the Hauterivian–Aptian shows a complex phylogenetic mosaic, including forms with Laurasian affinities, mainly titanosauriforms (Soriatitan, Garumbatitan, and possibly Tastavinsaurus and Europatitan), and Gondwanan affinities, the rebbachisaurid Demandasaurus. Faunal exchange during the Early Cretaceous between the Europe, North America, East Asia, and Africa is plausible.
Psychometric Properties of Patient-reported Outcome Measures to Assess Resilience in Individuals with Musculoskeletal Pain or Rheumatic Conditions
Authors: Rosa Dayana Patricia , Dubé Marc-Olivier , Roy Jean-Sébastien
Published: September 2023

Objectives:

The objective of this systematic review was to provide a comprehensive overview of the measurement properties of patient-reported outcome measures (PROMs) used to assess resilience in individuals with musculoskeletal and rheumatic conditions.

Methods:

Four electronic databases (MEDLINE, CINAHL, PsycINFO, Web of Science) were searched. Studies assessing any measurement property in the target populations were included. Two reviewers independently screened all studies and assessed risk of bias using the COSMIN checklist. Thereafter, each measurement property of each PROM was classified as sufficient, insufficient, or inconsistent based on the COSMIN criteria for good measurement properties.

Results:

Four families of PROMs (Brief Resilient Coping Scale [BRCS]; Resilience Scale [RS-18]; Connor–Davidson Resilience Scale [CD-RISC-10 and CD-RISC-2]; and Pain Resilience Scale [PRS-14 and PRS-12]) were identified from the 9 included studies. Even if no PROM showed sufficient evidence for all measurement properties, the PRS and CD-RISC had the most properties evaluated and showed the best measurement properties; although responsiveness still needs to be assessed for both PROMs. Both PROMs showed good level of reliability (intraclass coefficient correlation 0.61 to 0.8) and good internal consistency (Cronbach’s alpha ≥0.70). Minimal detectable change values were 24.5% for PRS and between 4.7% and 29.8% for CD-RISC.

Discussion:

Although BRCS, RS-18, CD-RISC or PRS have been used to evaluated resilience in individuals with musculoskeletal and rheumatic conditions, the current evidence only supports the use of PRS or CD-RISC in this population. Further methodological studies are therefore needed and should prioritize the assessment of reliability and responsiveness.
Sleep Disruptions in Hospitalized Adults Sustaining a Traumatic Brain Injury: A Scoping Review
Authors: Leclerc Catherine , Gervais Charles , Hjeij Danny , Briand Marie-Michèle , Williamson David , Bernard Francis , Duclos Catherine , Arbour Caroline
Published: September 2023

Objective:

Adults sustaining a traumatic brain injury (TBI) are at risk of sleep disturbances during their recovery, including when such an injury requires hospitalization. However, the sleep-wake profile, and internal and external factors that may interfere with sleep initiation/maintenance in hospitalized TBI patients are poorly understood. This review aimed to: (1) identify/summarize the existing evidence regarding sleep and sleep measurements in TBI adults receiving around-the-clock care in a hospital or during inpatient rehabilitation, and (2) identify internal/external factors linked to poor sleep in this context.

Methods:

A scoping review was conducted in accordance with the PRISMA Scoping Review Extension guidelines. A search was conducted in MEDLINE, PsycINFO, CINAHL, and Web of Science databases.

Results:

Thirty relevant studies were identified. The most common sleep variables that were put forth in the studies to characterize sleep during hospitalization were nighttime sleep time (mean = 6.5 hours; range: 5.2-8.9 hours), wake after sleep onset (87.1 minutes; range: 30.4-180 minutes), and sleep efficiency (mean = 72.9%; range: 33%-96%) using mainly actigraphy, polysomnography, and questionnaires (eg, the sleep-wake disturbance item of the Delirium Rating Scale or the Pittsburgh Sleep Quality Index). Twenty-four studies (80%) suggested that hospitalized TBI patients do not get sufficient nighttime sleep, based on the general recommendations for adults (7-9 hours per night). Sleep disruptions during hospitalization were found to be associated to several internal factors including TBI severity, cognitive status, and analgesia intake. External and modifiable factors, such as noise, light, and patient care, were consistently associated with sleep disruptions in this context.

Conclusion:

Although the literature on sleep disturbances in hospitalized TBI patients has been increasing in recent years, many gaps in knowledge remain, including phenotypes and risk factors. Identifying these factors could help clinicians better understand the multiple sources of TBI patients' sleep difficulties and intervene accordingly.
A CASE OF EPSTEIN–BARR VIRUS–ASSOCIATED PRIMARY VITREORETINAL LYMPHOMA IN AN IMMUNOSUPPRESSED PATIENT
Authors: Sun Chunxiao , Muraoka Yuki , Ishihara Kenji , Morooka Satoshi , Akada Masahiro , Hata Masayuki , Tsujikawa Akitaka
Published: September 2023

Purpose:

To describe a rare case of Epstein–Barr virus (EBV)-positive primary vitreoretinal lymphoma in an immunosuppressed patient.

Methods:

Observational case report.

Results:

A 64-year-old man under immunosuppressive therapy for rheumatic arthritis was referred for 2 months of blurred vision and decreased visual acuity in the right eye. Only mutton-fat keratic precipitates and mild vitreous opacity were found in the right eye without (sub)retinal or sub-retinal pigment epithelial lesions. Vitreous biopsy and systemic workup suggested the diagnosis of primary vitreoretinal lymphoma of diffuse large B-cell lymphoma subform. Neoplastic cells stained positive for EBV antigens, EBV-encoded small RNA, and Epstein–Barr nuclear antigen 2, consistent with EBV-positive diffuse large B-cell lymphoma. Intravitreal methotrexate was effective in improving ocular symptoms.

Conclusion:

The case provided evidence on the association of EBV infection with primary vitreoretinal lymphoma.
Capsular phimosis with intraocular lens tilt and decentration
Authors: Chee Soon-Phaik , Dick H. Burkhard , Masket Samuel , Beltz Jacqueline , Vajpayee Rasik B. , Yeu Elizabeth , Zhu Dagny
Published: September 2023

A 34-year-old woman with quiescent bilateral intermediate uveitis maintained on once-daily dexamethasone 0.1% eyedrops, complicated by left cataract and glaucoma controlled with a single antiglaucoma medication, presented for cataract surgery. Her left corrected distance visual acuity (CDVA) was 20/40 because of a posterior subcapsular lens opacity. The anterior chamber angles appeared closed in all 4 quadrants on gonioscopy. Ultrasound biomicroscopy (UBM) confirmed the gonioscopy findings and, in addition, revealed a crystalline lens thickness of 5.53 mm, normal ciliary body structure, and multiple localized chorioretinal scars with membranes over the pars plana region. She underwent left phacoemulsification, goniosynechiolysis, and in-the-bag implantation of a single-piece monofocal hydrophobic acrylic intraocular lens (IOL).

On the first postoperative day, she achieved pinhole vision of 20/70 (−6 diopters [D] myopia to balance with the fellow eye). There was mild anterior chamber cellular activity and flare, consistent with postoperative inflammation. Her intraocular pressure (IOP) was 16 mm Hg without antiglaucoma therapy. She was advised to continue the prednisolone acetate 1% eyedrops 6 times daily and to reduce it to 4 times daily after a week for the next 4 weeks. At 1 month, she was refracted to 20/40 N5, and the eye was quiescent. Optical coherence tomography showed that the macular was normal. The topical steroids were gradually tapered to the preoperative level.

However, a month later, she returned complaining of deteriorating vision while using twice-daily steroid eyedrops. Her CDVA was 20/60. Slitlamp examination revealed anterior capsule fibrosis and capsular phimosis, resulting in partial obstruction of the visual axis and mild decentration of the IOL superior temporally (Figure 1

JOURNAL/jcrs/04.03/02158034-202310000-00013/figure1/v/2023-10-10T172638Z/r/image-tiff

). The anterior segment was quiescent. The pupil could only be dilated to 4.5 mm despite the absence of posterior synechiae. Fundus examination revealed a normal-looking quiescent posterior segment. Her IOP was 16 mm Hg. UBM showed a thickened anterior capsule, intact zonular fibers, and a posteriorly bowed and decentered IOL within the capsular bag (Figure 2

JOURNAL/jcrs/04.03/02158034-202310000-00013/figure2/v/2023-10-10T172638Z/r/image-tiff

). She was referred for further management.

Discuss how you would manage this problem, explaining your decisions. How would you be able to avoid the same problem when operating on her fellow eye?
Sensing the body matters: profiles of interoceptive sensibility in chronic pain adjustment
Authors: Oliveira Inês , Vaz Garrido Margarida , Carvalho Helena , Figueira Bernardes Sónia
Published: September 2023

Interoception is critical to health regulation and is often disrupted in individuals with chronic pain (ICPs). Interoceptive sensibility (IS)—the self-reported experience and relationship toward internal states—includes skills such as sensing, interpreting, and using bodily information for self-regulation. Current studies on IS and chronic pain (CP) adjustment are scarce, and how the interplay between different IS skills shapes CP adjustment remains unclear. This cross-sectional study aimed to identify profiles of IS skills among ICPs and examined their associations with pain outcomes and psychological and behavioral risk or protective processes. Individuals with chronic musculoskeletal pain (n = 173; 84.4% women) completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), measures of CP adjustment (depression, anxiety, vitality, pain severity, interference, and physical function), psychological (self-efficacy, catastrophizing, and kinesiophobia), and behavioral processes (activity patterns). A cluster analysis identified 3 IS skills profiles: (1) high IS skills (n = 68), with the highest levels of attention regulation toward bodily sensations, body trust, listening for insight, and self-regulation; (2) low IS skills (n = 29), who distracted less and worried more about bodily sensations, and presented lower-body trust; and (3) mixed IS skills (n = 71), despite good body trust, attention regulation, and low worrying, showed lower awareness of body–mind connections. Interoceptive sensibility skills profiles differed in depression, vitality (fatigue), and psychological or behavioral processes, such as pain-related self-efficacy, catastrophizing, kinesiophobia, and activity pacing. These findings contribute to integrating body–mind connections more explicitly into current theoretical CP models and developing tailored interventions targeting specific IS skills to improve CP adjustment.
Acute and Longer-Term Effects of COVID-19 on Auditory and Vestibular Symptoms
Authors: Berlot Ashley A. , Moskowitz Howard S. , Lin Juan , Liu Jianyou , Sehanobish Esha , Jerschow Elina , Ow Thomas J. , Sussman Elyse S.
Published: September 2023

Objective

To evaluate long-term effects of COVID-19 on auditory and vestibular symptoms in a diverse cohort impacted by the initial 2020 COVID-19 infection in the pandemic's epicenter, before vaccine availability.

Study Design

Cohort study of individuals with confirmed COVID-19 infection, diagnosed in the March–May 2020 infection wave. A randomized, retrospective chart review of 1,352 individuals was performed to identify those with documented new or worsening auditory (aural fullness, tinnitus, hyperacusis, hearing loss) or vestibular (dizziness, vertigo) symptoms. Those with documented symptoms (613 of the 1,352 initial cohort) were contacted for a follow-up telephone survey in 2021–2022 to obtain self-report of aforementioned symptoms.

Setting

Academic tertiary hospital system in Bronx, NY.

Patients

Adults 18 to 99 years old with confirmed COVID-19 infection, alive at time of review. One hundred forty-eight charts were excluded for restricted access, incomplete data, no COVID-19 swab, or deceased at time of review.

Intervention

Confirmed COVID-19 infection, March to May 2020.

Main Outcomes Measures

Auditory and vestibular symptoms documented in 2020 medical records and by self-report on 2021 to 2022 survey.

Results

Among the 74 individuals with documented symptoms during the first 2020 COVID-19 wave who participated in the 2021 to 2022 follow-up survey, 58% had documented vestibular symptoms initially in 2020, whereas 43% reported vestibular symptoms on the 2021 to 2022 survey (p = 0.10). In contrast, 9% had documented auditory symptoms initially in 2020 and 55% reported auditory symptoms on the 2021 to 2022 survey (p < 0.01).

Conclusions

COVID-19 may impact vestibular symptoms early and persistently, whereas auditory effects may have more pronounced long-term impact, suggesting the importance of continually assessing COVID-19 patients.
Implementing Evidence-Based Workplace Violence Prevention Education to Support Frontline Staff at Risk for Workplace Violence
Authors: Varty Maureen , Mines Megan , DelMonte JoAnn , Ratliff Billie
Published: September 2023

Prior studies assessing workplace violence educational interventions have found positive outcomes including increased frontline staff confidence and reduced restraint utilization. An electronic, evidenced-based educational module was provided to frontline staff across a large healthcare system in response to a gap found during analysis of workplace violence prevention initiatives. This quality improvement project found that education can be feasibly implemented across large healthcare organizations to improve frontline staff vigilance and awareness of workplace violence risks.
The Spectrum of HPV-independent Penile Intraepithelial Neoplasia
Authors: Regauer Sigrid , Ermakov Mikhail , Kashofer Karl
Published: September 2023

Compared with vulva, precursor lesions of human papillomavirus (HPV)-independent invasive squamous cell carcinoma (SCC) of the penis are insufficiently characterized. We analyzed the histologic and immunohistochemical characteristics of 70 peritumoral precursor lesions and correlated them with the histology and mutational profile of the adjacent HPV-negative invasive penile SCC. Atypical basal keratinocyte proliferation with variously elongated epithelial rete with premature squamatiziation, but regular superficial cornification, termed differentiated penile intraepithelial neoplasia (d-PeIN), were identified adjacent to 42/70 (60%) SCC (36/42 keratinizing (P<0.001); 3 papillary, and 1 each verrucous, clear cell, sarcomatoid SCC). d-PeIN were associated with chronic inflammatory dermatoses (32/42; P<0.001), p53 overexpression (26/42; P<0.001), and hotspot mutations in TP53 (32/42; P<0.001), CDKN2A (26/42; P<0.001) or both (21/42; P=0.003) in the adjacent SCC. Cytoplasmic p16ink4a overexpression in 5/42 d-PeIN correlated with CDKN2A missense mutations in the adjacent SCC. In all, 21/70 (30%) cornified verrucous or glycogenated verruciform precursors with minimal atypia and wild-type p53 (18/21; P<0.001) occurred adjacent to verrucous or papillary SCC (17/21; P<0.001) and keratinizing (4/21) SCC, which harbored mutations in HRAS and/or PIK3CA (12/21; P<0.004). Undifferentiated p16ink4a-negative full-thickness precursors were identified in 7/70 (10%) SCC. Four histologically different HPV-independent penile precursor lesions can be assigned to 2 major genetic/biological pathways with characteristic highly differentiated precursors requiring different clinical management decisions. These include d-PeIN in chronic inflammatory dermatoses, with p53 overexpression and TP53/CDKN2A mutations, and the p53 wild-type verrucous and verruciform precursors unassociated with dermatoses, but with mutations in oncogenes PIK3CA and HRAS.
Improving Situational Awareness to Decrease Emergency ICU Transfers for Hospitalized Pediatric Cardiology Patients
Authors: Cosgrove Tara C. , Gajarski Robert J. , Dolan Kevin F. , Hart Stephen A. , L’Italien Kaitlin E. , Kuehn Stacy , Ishmael Stephanie , Bowman Jessica L. , Fitch Jill A. , Hills Brittney K. , Bode Ryan S.
Published: September 2023

Introduction:

Failure to recognize and mitigate critical patient deterioration remains a source of serious preventable harm to hospitalized pediatric cardiac patients. Emergency transfers (ETs) occur 10–20 times more often than code events outside the intensive care unit (ICU) and are associated with morbidity and mortality. This quality improvement project aimed to increase days between ETs and code events on an acute care cardiology unit (ACCU) from a baseline median of 17 and 32 days to ≥70 and 90 days within 12 months.

Methods:

Institutional leaders, cardiology-trained physicians and nurses, and trainees convened, utilizing the Institution for Healthcare Improvement model to achieve the project aims. Interventions implemented focused on improving situational awareness (SA), including a “Must Call List,” evening rounds, a visual management board, and daily huddles. Outcome measures included calendar days between ETs and code events in the ACCU. Process measures tracked the utilization of interventions, and cardiac ICU length of stay was a balancing measure. Statistical process control chart methodology was utilized to analyze the impact of interventions.

Results:

Within the study period, we observed a centerline shift in primary outcome measures with an increase from 17 to 56 days between ETs and 32 to 62 days between code events in the ACCU, with sustained improvement. Intervention utilization ranged from 87% to 100%, and there was no observed special cause variation in our balancing measure.

Conclusions:

Interventions focused on improving SA in a particularly vulnerable patient population led to sustained improvement with reduced ETs and code events outside the ICU.