bluuebunny/crossref_metadata_2025 huggingface dataset:
Rejecting your Reality
Authors: Stahlke Samantha , Mirza-Babaei Pejman
Published: September 2022

Virtual reality (VR) offers an unprecedented level of immersion in player interaction, having established itself in the games market as a relatively niche platform, at least for the time being. Designing VR interactions is substantially different both in terms of game communication and player input, bringing a variety of challenges. Head-mounted displays offer a rich visual experience, but they can also induce motion sickness if designers aren’t careful about how they take players through a virtual world. Novel controllers present opportunities for gestural interaction, but a wide variety of hardware makes preserving consistency difficult. This chapter addresses these challenges, exploring solutions to common VR design conundrums like player locomotion and camera design. It also discusses opportunities in designing games that creatively take advantage of features specific to VR, such as room-scale physical interaction.
Specifying Poverty Lines
Authors: Kakwani Nanak , Son Hyun H.
Published: September 2022

There are two distinct issues in the measurement of poverty. The first issue is identifying the poor, and the second one is constructing an aggregate poverty index, measuring the degree of suffering by a society. The literature on poverty measurement has primarily focused on the second issue. A poverty line is a practical tool used to identify the poor. This chapter offers a new model for constructing a poverty line, defining society’s minimum acceptable standard of living in monetary units and using consumer theory to generate food and non-food poverty lines. The methodology developed is applied to construct poverty thresholds to the data obtained from Pakistan. This chapter also surveys the literature on the construction of global poverty lines to produce global poverty counts. It provides a critical evaluation of the World Bank methodology to construct a global poverty threshold, suggesting an advanced method.
Normative Measures of Tax Progressivity
Authors: Kakwani Nanak , Son Hyun H.
Published: September 2022

The public debates on taxation revolve around tax progressivity and the redistribution effects of taxation. It is, therefore, essential to assess the extent to which tax systems lead to social welfare gains or losses. However, the literature on taxation has yet to explore the social welfare implications of the measures of progressivity. This chapter has undertaken a pioneering effort to develop a social welfare function framework for deriving tax progressivity measures and exploring their social welfare implications. This social welfare framework has helped derive progressivity measures from eight alternative social welfare functions. Every tax progressivity measure has an implicity social welfare function that determines the society’s normative values. The chapter concludes that optimizing social welfare requires three factors: (i) a progressive tax system, (ii) minimum administrative costs for collecting taxes, and (iii) efficient investments of tax revenues to maximize the social rates of return.
Poverty Price Indices
Authors: Kakwani Nanak , Son Hyun H.
Published: September 2022

Prices play an essential role in people’s lives. If society’s concern is to protect the poor, knowing how prices affect them is crucial. The main objective of this chapter is to measure the impact of price changes on poverty. The chapter has achieved this objective by developing a new consumer demand theory methodology. Developing countries collect a significant amount of revenue from indirect taxes. How should governments determine tax rates on various goods and services? These rates have both direct and indirect impacts on the prices of goods and services. Governments can determine these tax rates to have a minimum effect on poverty. The poverty elasticity with respect to prices and the pro-poor index developed in the chapter provides valuable tools to determine tax rates. This chapter also creates a price index for the poor, systematically capturing the poor’s consumption patterns through poverty price elasticity. While this index can be computed for any poverty measure, this chapter has focused on three poverty measures: the head-count ratio, the poverty gap ratio, and the severity of poverty. All three poverty measures show that Brazil’s price changes during the 1999–2006 period have favored the non-poor proportionally more than the poor.
The origin of ergative case markers
Authors: Luraghi Silvia , Inglese Guglielmo
Published: September 2022

Hittite neuter nouns must take a dedicated -ants/antes form when occurring as the subject of a transitive verb. There is still no consensus on the interpretation of this pattern: for some scholars -ant- is a derivational suffix indicating gender motion from neuter to common gender. Others regard -ants as an ergative case marker, assuming that Hittite features a gender-based split-ergativity system. This chapter discusses evidence on the distribution of -ants nouns in chronologically ordered Hittite texts, showing that the suffix started out as derivational in Old Hittite, becoming an ergative case ending in New Hittite. We assess the semantics of the suffix at its derivational stage compared with other -ant- formations, showing how its various functions facilitated its development into an ergative marker. We also discuss the reconstruction of alignment in Proto-Anatolian, compared with areal tendencies in ancient Anatolia, framing the Hittite developments within typological data on the rise of ergativity.
Infinitives and subjecthood between Latin and Old Italian
Authors: Fabrizio Claudia
Published: September 2022

The chapter examines the syntactic behaviour of a special class of non-canonical subjects, namely nominal infinitives, in Latin and in one of its daughter languages, Old Italian. The data show that Latin infinitives can appear in subject function only if the finite verb of the clause belongs to a restricted set of unaccusative predicates, corresponding to states or telic changes of state. In other words, Latin infinitives cannot surface as subjects of unergative and transitive predicates, thus conforming to a widespread cross-linguistic trend concerning non-canonical subjects. Vice versa, the distribution of subject infinitives in Old Italian is unrestricted, insofar as they are eligible to subjecthood regardless of the finite verb of the clause. The hypothesis this chapter explores is that the change which took place from Latin to Old Italian, involving the syntactic status of nominal infinitives, might have started from the clauses with a finite experiencer predicate.
Alignment changes with Spanish experiential verbs
Authors: Melis Chantal
Published: September 2022

Experiential verbs have a tendency to exhibit a variety of argument patterns across and within languages. The concern in the present chapter lies with a group of emotional predicates from Spanish, which in their basic transitive use assign the subject function to the stimulus and the direct object role to the experiencer, but which allow for three alternative mappings serving to upgrade the experiencer, while simultaneously signalling the affected condition of the promoted human participant. The alternatives encompass a middle voice structure, a non-canonical dative valence frame, and, unexpectedly, a type of patient subject construction reminiscent of ‘active’ alignment systems. The three coding strategies are first characterised from a typological point of view and the ensuing discussion focuses on their development in Spanish with the emotional verbs under study.
Fortune’s Early Modern Turn
Authors: Degenhardt Jane Hwang
Published: September 2022

This substantial introductory chapter offers a detailed overview of the economic, religious, imperial, and philosophical contexts for understanding the expanding role of fortune in early modern England. It includes a discussion of the radical shifts in fortune’s meaning from the classical and medieval periods into the Renaissance, including an overview of major philosophical and poetic treatments of the topic by writers ranging from Boethius to Machiavelli to John Dee. It also includes a consideration of fortune’s evolving iconographical tradition in the sixteenth century (including a discussion of more than a dozen images). Finally, it sets forth an argument about the popular theater’s role in authorizing a new meaning of fortune that offered a model for maximizing and ethically justifying new global investment practices as well as its own reliance on paying audiences, outside investors, and commercial profits.
The Politics of Investment Treaties in Latin America
Authors: Calvert Julia
Published: September 2022

International investment law is at a crossroads. Civil society groups, prominent think tanks, and international organizations are calling for widespread reform. At the centre of controversy are international investment agreements (IIAs) and investor-state dispute settlement (ISDS). Over 1,000 legal claims have been brought by foreign investors under IIAs since the mid-1990s, resulting in multimillion-dollar fines imposed against governments for policies related to the environment, natural resource governance, and access to basic services among other areas of public concern. Governments targeted by investor claims are pursuing a variety of reforms that range from the incremental to paradigm-shifting. These different responses raise important questions about the politics of infringement and reform. Why do governments infringe on IIAs despite the costs of doing so? Why do some governments heavily targeted by investor claims pursue more substantive reforms than others? This book provides a timely examination of infringement and reform in Latin America, where governments felt the sting of investor claims sooner and with greater frequency than in other regions. It focuses on Peru, Argentina, and Ecuador, countries that responded very differently to waves of investor claims. Based on interviews with government officials and international lawyers, as well as an extensive analysis of legal transcripts, detailed case study chapters examine the conditions that prompted investor claims and the factors that inform countries’ reform agendas. In doing so, the book illustrates the conditions under which IIAs constrain state behaviour and how different belief systems produce different responses to external pressures for treaty compliance.
The Contested History of Investment Treaties in Latin America
Authors: Calvert Julia
Published: September 2022

This chapter illustrates the roles Latin American elites played in establishing international investment protection standards. The origins of international investment law are complex. Intellectuals and practitioners from capital-exporting countries shaped its nature and scope, but they did not dictate investment protection standards alone. Latin American elites and other global South actors influenced the content and reach of investment rules over time. And they did so in tune with evolving beliefs about the role of the state in promoting economic growth and social welfare. The chapter begins with the nineteenth century when Latin American governments opposed Western efforts to impose principles of customary international law. Both sides professed liberal values but held fundamentally different views about the duty of care owed to foreign nationals in newly independent states. It then discusses alternative standards of protection developed by Latin American elites, which circumscribed investor rights until the 1980s. Finally, it addresses the proliferation of IIAs in the 1990s. It shows that Latin American governments did not simply react to external incentives in signing IIAs. How governments viewed their role in domestic economic management fundamentally changed, leading to a greater willingness to surrender state sovereignty in exchange for anticipated economic progress.
Argentina
Authors: Calvert Julia
Published: September 2022

Argentina is the most frequently litigated country under international investment agreements (IIAs). Multimillion-dollar losses prompted staunch opposition from government and civil society. Yet, Argentina did not terminate IIAs as did other Latin American countries. Instead, it refused to pay arbitral awards and infringed repeatedly on its agreements. This chapter asks why would a government infringe repeatedly on IIAs despite rising costs? Why would a country heavily targeted by investor claims fail to reduce its IIA commitments? It focuses on the governments of Néstor Kirchner and Cristina Fernández de Kirchner. The Kirchner governments embraced a softer form of market-led development that emphasized the state’s role in protecting citizens from market insecurities. They were unwilling to offer concessions to affected investors that would stave off arbitral rulings because this risked reducing access to public services for the poor and marginalized. Policymakers also sought to reverse the most contested aspects of privatization, which led to infringement. Yet, they were also willing participants in the global capitalist system and believed that IIAs help attract foreign investment. While they contested perceived bias in arbitration, they believed IIAs would generate long-term benefits once the short-term costs of infringement were absorbed.
A Wide and Deep Exploration of Radio Galaxies with Subaru HSC (WERGS). IX. The most overdense region atz∼ 5 inhabited by a massive radio galaxy
Authors: Uchiyama Hisakazu , Yamashita Takuji , Nagao Tohru , Ono Yoshiaki , Toshikawa Jun , Ichikawa Kohei , Kawakatu Nozomu , Kajisawa Masaru , Toba Yoshiki , Matsuoka Yoshiki , Kubo Mariko , Imanishi Masatoshi , Ito Kei , Kawaguchi Toshihiro , Lee Chien-Hsiu , Saito Tomoki
Published: September 2022

We report on the galaxy density environment around a high-z radio galaxy (HzRG) at z = 4.72, HSC J083913.17+011308.1 (HSC J0839+0113), probed using an r-dropout Lyman break galaxy (LBG) sample from the Hyper Suprime-Cam Subaru Strategic Program data. We find that HSC J0839+0113 resides in the outskirts of an overdense region identified by the r-dropout galaxies at a 4.7σ significance level. The projected distance between HSC J0839+0113 and the peak position of the overdense region is 0.4 physical Mpc, which is shorter than the typical protocluster radius in this epoch. According to the extended Press–Schechter and the light cone models, the HSC J0839+0113-hosted overdense region is expected to evolve into a halo >1014 ${M_{\odot}}$ at z = 0 with a high probability of $>\!\! 80\%$. These findings suggest that HSC J0839+0113 is associated with a protocluster. The HSC J0839+0113 rich-system is the most overdense region of LBGs among the known protoclusters with LBGs in the same cosmic epoch.
Spatiotemporal dynamics of the tomato fruit transcriptome under prolonged water stress
Authors: Nicolas Philippe , Shinozaki Yoshihito , Powell Adrian , Philippe Glenn , Snyder Stephen I , Bao Kan , Zheng Yi , Xu Yimin , Courtney Lance , Vrebalov Julia , Casteel Clare L , Mueller Lukas A , Fei Zhangjun , Giovannoni James J , Rose Jocelyn K C , Catalá Carmen
Published: September 2022

Water availability influences all aspects of plant growth and development; however, most studies of plant responses to drought have focused on vegetative organs, notably roots and leaves. Far less is known about the molecular bases of drought acclimation responses in fruits, which are complex organs with distinct tissue types. To obtain a more comprehensive picture of the molecular mechanisms governing fruit development under drought, we profiled the transcriptomes of a spectrum of fruit tissues from tomato (Solanum lycopersicum), spanning early growth through ripening and collected from plants grown under varying intensities of water stress. In addition, we compared transcriptional changes in fruit with those in leaves to highlight different and conserved transcriptome signatures in vegetative and reproductive organs. We observed extensive and diverse genetic reprogramming in different fruit tissues and leaves, each associated with a unique response to drought acclimation. These included major transcriptional shifts in the placenta of growing fruit and in the seeds of ripe fruit related to cell growth and epigenetic regulation, respectively. Changes in metabolic and hormonal pathways, such as those related to starch, carotenoids, jasmonic acid, and ethylene metabolism, were associated with distinct fruit tissues and developmental stages. Gene coexpression network analysis provided further insights into the tissue-specific regulation of distinct responses to water stress. Our data highlight the spatiotemporal specificity of drought responses in tomato fruit and indicate known and unrevealed molecular regulatory mechanisms involved in drought acclimation, during both vegetative and reproductive stages of development.
Abscisic acid modulates neighbor proximity-induced leaf hyponasty in Arabidopsis
Authors: Michaud Olivier , Krahmer Johanna , Galbier Florian , Lagier Maud , Galvão Vinicius Costa , Ince Yetkin Çaka , Trevisan Martine , Knerova Jana , Dickinson Patrick , Hibberd Julian M , Zeeman Samuel C , Fankhauser Christian
Published: September 2022

Leaves of shade-avoiding plants such as Arabidopsis (Arabidopsis thaliana) change their growth pattern and position in response to low red to far-red ratios (LRFRs) encountered in dense plant communities. Under LRFR, transcription factors of the phytochrome-interacting factor (PIF) family are derepressed. PIFs induce auxin production, which is required for promoting leaf hyponasty, thereby favoring access to unfiltered sunlight. Abscisic acid (ABA) has also been implicated in the control of leaf hyponasty, with gene expression patterns suggesting that LRFR regulates the ABA response. Here, we show that LRFR leads to a rapid increase in ABA levels in leaves. Changes in ABA levels depend on PIFs, which regulate the expression of genes encoding isoforms of the enzyme catalyzing a rate-limiting step in ABA biosynthesis. Interestingly, ABA biosynthesis and signaling mutants have more erect leaves than wild-type Arabidopsis under white light but respond less to LRFR. Consistent with this, ABA application decreases leaf angle under white light; however, this response is inhibited under LRFR. Tissue-specific interference with ABA signaling indicates that an ABA response is required in different cell types for LRFR-induced hyponasty. Collectively, our data indicate that LRFR triggers rapid PIF-mediated ABA production. ABA plays a different role in controlling hyponasty under white light than under LRFR. Moreover, ABA exerts its activity in multiple cell types to control leaf position.
Cell reorientation on a cyclically strained substrate
Authors: Das Shuvrangsu , Ippolito Alberto , McGarry Patrick , Deshpande Vikram S
Published: September 2022

Cyclic strain avoidance, the phenomenon of cell and cytoskeleton alignment perpendicular to the direction of cyclic strain of the underlying 2D substrate, is an important characteristic of the adherent cell organization. This alignment has typically been attributed to the stress-fiber reorganization although observations clearly show that stress-fiber reorganization under cyclic loading is closely coupled to cell morphology and reorientation of the cells. Here, we develop a statistical mechanics framework that couples the cytoskeletal stress-fiber organization with cell morphology under imposed cyclic straining and make quantitative comparisons with observations. The framework accurately predicts that cyclic strain avoidance stems primarily from cell reorientation away from the cyclic straining rather than cytoskeletal reorganization within the cell. The reorientation of the cell is a consequence of the cell lowering its free energy by largely avoiding the imposed cyclic straining. Furthermore, we investigate the kinetics of the cyclic strain avoidance mechanism and demonstrate that it emerges primarily due to the rigid body rotation of the cell rather than via a trajectory involving cell straining. Our results provide clear physical insights into the coupled dynamics of cell morphology and stress-fibers, which ultimately leads to cellular organization in cyclically strained tissues.
Continuing specialist care into adulthood in young people with juvenile idiopathic arthritis: a retrospective cohort study using electronic health records in England
Authors: Costello Ruth E , Kearsley-Fleet Lianne , McDonagh Janet E , Hyrich Kimme L , Humphreys Jenny H
Published: September 2022

Objectives

This study aimed to measure (1) the proportion of children who continue to receive specialist care (rheumatology/ophthalmology) as adults, (2) the characteristics associated with continuing specialist care, and (3) the frequency of specialist care appointments in both paediatric and adult services.

Methods

A retrospective cohort of young people with JIA was identified from UK primary care electronic health records (Clinical Practice Research Datalink) between 1 April 2003 and 31 December 2018. To be included in the study, cases needed to have at least 1 year of registration at their general practice beyond age 18 and linkage to Hospital Episodes Statistics data for secondary care information. All specialist care outpatient visits were identified from Hospital Episodes Statistics outpatient data.

Results

There were 666 young people included in the study. Of these, 427 (64%) received specialist care beyond age 18, 90 (13%) had their last recorded contact at 16–17 years and 149 (22%) did not continue after 16 years. Older age at diagnosis, female gender, less deprivation and a childhood diagnosis of uveitis were associated with continuing specialist care beyond age 18. Of those continuing beyond 18, 35% (n = 153) were subsequently discharged by the study end date. Of all those discharged, 32% had a missed appointment recorded after the last attended visit, suggesting failure to attend.

Conclusions

Two-thirds of young people with JIA continue to receive specialist care beyond age 18. This is useful information for children and young people with JIA and their families planning for their future, and for clinicians planning health-care services.
Concept Note: Toward Metagenomic Sequencing for Rapid, Sensitive, and Accurate Detection of Bacterial Pathogens in Potato Seed Production
Authors: Roman-Reyna Veronica , Rioux Renee , Babler Brooke , Klass Taylor , Jacobs Jonathan
Published: September 2022

Disease-free planting stocks and formal certification systems are critical for the profitable production of vegetatively propagated crops. Propagation through seed tubers is the standard and preferred process for potato production. Seed tuber certification systems are used in the United States and throughout the world to mitigate degeneration and promote the use of high-quality planting stocks. Seed certification uses molecular and serological diagnostic methods for stock testing. While the molecular assays available are well-validated and offer high sensitivity, the rapidly evolving pathogens they target routinely develop mutations that allow them to evade detection. Examples of these limitations are the potato diseases soft rot and blackleg, caused by Pectobacterium and Dickeya species. These diseases are challenging for current diagnostics tools because of high pathogen genomic variability, identical symptom development, and co-infections. Given the rapidly changing genetics of soft rot and blackleg bacteria, metagenomic sequencing should be adopted as a tool for routine validation of currently accepted diagnostic methods, and for the development of new diagnostic assays. We propose metagenome sequencing usage to enhance the diagnostic capabilities and complement molecular epidemiology approaches. We envision that metagenomics will accelerate diagnosis, shorten response time to outbreaks caused by unknown microorganisms, and provide more accurate and sustainable management strategies for seed certification programs.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Interpretive Methodologies in Qualitative Nursing Research
Authors: Curtis Alexa Colgrove , Keeler Courtney
Published: September 2022

Editor's note: This is the 12th article in a series on clinical research by nurses. The series is designed to give nurses the knowledge and skills they need to participate in research, step by step. Each column will present the concepts that underpin evidence-based practice—from research design to data interpretation. To see all the articles in the series, go to https://links.lww.com/AJN/A204.
Design of novel quinoline derivatives as antibreast cancer using 3D-QSAR, molecular docking and pharmacokinetic investigation
Authors: El Rhabori Said , El Aissouq Abdellah , Chtita Samir , Khalil Fouad
Published: September 2022

Breast cancer has been one of the most challenging women’s cancers and leading cause of mortality for decades. There are several studies being conducted all the time to find a cure for breast cancer. Quinoline derivatives have shown their potential as antitumor agents in breast cancer therapy. In this work, three-dimensional quantitative structure-activity relationships (3D-QSAR) and molecular docking with aromatase enzyme (Protein Data Bank: 3S7S) studies were performed to suggest the current scenario of quinoline derivatives as antitumor agents and to refine the path of these derivatives to discover and develop new drugs against breast cancer. For developing the 3D-QSAR model, comparative molecular similarity indices analysis (CoMSIA) and comparative molecular field analysis (CoMFA) were included. To attain the high level of predictability, the best CoMSIA model was applied. External validation utilizing a test set has been used in order to validate the predictive capabilities of the built model. According to the findings, electrostatic, hydrophobic and hydrogen bond donor, and acceptor fields had a significant impact on antibreast cancer activity. Thus, we generated a variety of novel effective aromatase inhibitors based on prior findings and we predicted their inhibitory activity using the built model. In addition, absorption, distribution, metabolism, elimination and toxicity properties were employed to explore the effectiveness of new drug candidates.
Probiotic immunonutrition impacts on colon cancer immunotherapy and prevention
Authors: Nami Yousef , Hejazi Salva , Geranmayeh Mohammad Hossein , Shahgolzari Mehdi , Yari Khosroushahi Ahmad
Published: September 2022

The important role of the immune system in treating cancer has attracted the attention of researchers to the emergence of oncology research. Immunotherapy has shown that the immune system is important in the fight against cancer. The challenge has led researchers to analyze the impact of immunotherapy on improving the status of the immune system, modifying the resulting safety response, reducing toxicity, and improving the results. This study aimed to discuss the potential mechanisms of probiotics in preventing colon cancer. The mechanisms include the change in intestinal microbiota, the metabolic activity of microbiota, the binding and degradation of the carcinogenic compounds present in the lumen of the intestine, the production of compounds with anticancer activity, immune system modification, intestinal dysfunction, changes in host physiology, and inhibition of cell proliferation and induction of apoptosis in cancerous cells. By contrast, very few reports have shown the harmful effects of oral probiotic supplements. According to available evidence, further studies on probiotics are needed, especially in identifying bacterial species with anticancer potential, studying the survival of the strains after passing the digestive tract, reviewing potential side effects in people with a weak immune system, and ultimately consuming and repeating its use. This study emphasizes that the nutritional formula can modulate inflammatory and immune responses in cancer patients. This effect reduces acute toxicity, although the pathways and measurement of this immune response are unclear. Nutrition safety is an emerging field in oncology, and further research is required.
Need for accelerating tobacco control in India: findings from the national cancer registry programme
Authors: Nath Anita , SathishKumar Krishnan , Das Priyanka , Lakshminarayana Sudarshan Kondalli , Santhappan Stephen , Natarajan Sathya , Karuppasamy Saravanaraj , Narasimhan Sandeep , Venkataiah Ramesha , Mathur Prashant
Published: September 2022

Objective

To describe the epidemiology of cancer in sites associated with tobacco use in India, according to recent findings from the National Cancer Registry Programme.

Methods

The data on cancers in sites associated with tobacco use has been sourced from 28 population-based and 58 hospital-based cancer registries of the National Cancer Registry Programme in India. The data covering a period of 5 years (2012–2016) was taken up for analysis.

Results

The highest age-adjusted incidence rate (AAR) among males was reported in the Aizawl district in Mizoram (197.3 per 100 000). The AAR was the highest (121.1 per 100 000) in the Papumpare district in females. The top five leading sites were cancers of the lung (10.7%), mouth (8.7%), oesophagus (6%), tongue (6%) and stomach (5%) among males and cancer of the cervix (10.3%), lung (4.3%), oesophagus (3.3%), mouth (3.3%) and tongue (2.7%) in females. The highest significant increase in AAR, indicated by the annual percentage change was seen among males in Aurangabad (3.4) and females in Kamrup urban (2.4). Except for lung cancer, most patients with other cancer types among both genders presented to the health facility with a locoregional (spread to nearby lymph nodes) disease spread. It is projected that in 2025, there will be 694367 cases of cancers in the sites associated with tobacco use.

Conclusion

Tobacco uses in either form and cancer in sites associated with tobacco use are an important matter of public health concern in India. Cancer registries play a crucial role in identifying populations with high cancer incidence in sites associated with tobacco use, monitoring the trends over time, and evaluating the impact of tobacco control measures.
Cervical cancer screening and outcomes for women under 25 years of age in Belgium: a 10-year nationwide study
Authors: Desimpel Fabian , Declercq Sabine , Makar Amin
Published: September 2022

Objective

The aim of the study was to describe trends in cervical cancer screening and outcomes for women under 25 years of age in Belgium between 2010 and 2019 in response to a changed reimbursement policy.

Materials and methods

We used the databases of the National Health Insurance Institute (RIZIV/INAMI) and the Belgian Cancer Registry (BCR) for a nationwide description of cervical screening, subsequent diagnostic procedures and outcomes for women younger than 20 years and women aged 20–25 years between 2010 and 2019.

Results

Over a 10-year period, the number of cytology screening tests and annual screening rates in women younger than 25 years have been reduced by 50%, but no increases in invasive cervical cancer or high-grade intraepithelial lesion diagnoses were observed. The major determinant of this decreased overscreening has been the limitation of reimbursement in 2013 to once every 3 years instead of once every 2 years. In women aged 25–29 years, there is no increase in invasive cervical cancer diagnoses after decreased screening of women younger than 25 years. To detect 29 invasive cervical cancers in women younger than 25 during the 10-year study period, a total of 5606 conizations were performed and 43 million EUR of Belgian health insurance budget was spent. Since the cost of hospitalization, sickness leave and negative psychological impact were not included in our estimation, these costs are underestimated.

Conclusion

Incidence of cervical cancer in women under 25 years remains low and screening is not effective in preventing cervical cancer, although there is clear evidence of potential reproductive harm and financial cost. We state that restricting reimbursement of cervical cancer screening before the age of 25 will improve guideline adherence and decrease healthcare expenditures without negatively impacting the health of the population.
Haemostatic support in postpartum haemorrhage
Authors: Hofer Stefan , Blaha Jan , Collins Peter W. , Ducloy-Bouthors Anne-Sophie , Guasch Emilia , Labate Francesco , Lança Filipe , Nyfløt Lill Trine , Steiner Kostja , Van de Velde Marc
Published: September 2022

Postpartum haemorrhage (PPH) remains the leading cause of pregnancy-related deaths worldwide. Typically, bleeding is controlled by timely obstetric measures in parallel with resuscitation and treatment of coagulopathy. Early recognition of abnormal coagulation is crucial and haemostatic support should be considered simultaneously with other strategies as coagulopathies contribute to the progression to massive haemorrhage. However, there is lack of agreement on important topics in the current guidelines for management of PPH. A clinical definition of PPH is paramount to understand the situation to which the treatment recommendations relate; however, reaching a consensus has previously proven difficult. Traditional definitions are based on volume of blood loss, which is difficult to monitor, can be misleading and leads to treatment delay. A multidisciplinary approach to define PPH considering vital signs, clinical symptoms, coagulation and haemodynamic changes is needed. Moreover, standardised algorithms or massive haemorrhage protocols should be developed to reduce the risk of morbidity and mortality and improve overall clinical outcomes in PPH. If available, point-of-care testing should be used to guide goal-directed haemostatic treatment. Tranexamic acid should be administered as soon as abnormal bleeding is recognised. Fibrinogen concentrate rather than fresh frozen plasma should be administered to restore haemostasis where there is elevated risk of fibrinogen deficiency (e.g., in catastrophic bleeding or in cases of abruption or amniotic fluid embolism) as it is a more concentrated source of fibrinogen. Lastly, organisational considerations are equally as important as clinical interventions in the management of PPH and have the potential to improve patient outcomes.
A Nonexercise Prediction of Peak Oxygen Uptake for Patients With Cardiovascular Disease
Authors: Peterman James E. , Arena Ross , Myers Jonathan , Ades Philip A. , Bonikowske Amanda R. , Harber Matthew P. , Marzolini Susan , Savage Patrick D. , Squires Ray W. , Lavie Carl J. , Kaminsky Leonard A.
Published: September 2022

Purpose:

Nonexercise predictions of peak oxygen uptake (V˙o
2peak) are used clinically, yet current equations were developed from cohorts of apparently healthy individuals and may not be applicable to individuals with cardiovascular disease (CVD). Our purpose was to develop a CVD-specific nonexercise prediction equation for V˙o
2peak.

Methods:

Participants were from the Fitness Registry and Importance of Exercise International Database (FRIEND) with a diagnosis of coronary artery bypass surgery (CABG), myocardial infarction (MI), percutaneous coronary intervention (PCI), or heart failure (HF) who met maximal effort criteria during a cardiopulmonary exercise test (n = 15 997; 83% male; age 63.1 ± 10.4 yr). The cohort was split into development (n = 12 798) and validation groups (n = 3199). The prediction equation was developed using regression analysis and compared with a previous equation developed on a healthy cohort.

Results:

Age, sex, height, weight, exercise mode, and CVD diagnosis were all significant predictors of V˙o
2peak. The regression equation was:

V˙o
2peak (mL · kg–1 · min–1) = 16.18 – (0.22 × age [yr]) + (3.63 × sex [male = 1; female = 0]) + (0.14 × height [cm]) – (0.12 × weight [kg]) + (3.62 × mode [treadmill = 1; cycle = 0]) – (2.70 × CABG [yes = 1, no = 0]) – (0.31 × MI [yes = 1, no = 0]) + (0.37 × PCI [yes = 1, no = 0]) – (4.47 × HF [yes = 1, no = 0]). Adjusted R2 = 0.43; SEE = 4.75 mL · kg–1 · min–1
.

Compared with measured V˙o
2peak in the validation group, percent predicted V˙o
2peak was 141% for the healthy cohort equation and 100% for the CVD-specific equation.

Conclusions:

The new equation for individuals with CVD had lower error between measured and predicted V˙o
2peak than the healthy cohort equation, suggesting population-specific equations are needed for predicting V˙o
2peak; however, errors associated with nonexercise prediction equations suggest V˙o
2peak should be directly measured whenever feasible.
Clear Cell Syringoma of the Eyelids, a Distinctive Histopathologic Variant Associated with Diabetes Mellitus
Authors: Lin Lisa Y. , Lee Nahyoung Grace , Yoon Michael K. , Stagner Anna M.
Published: September 2022

The authors describe the clinical and histologic findings of the clear cell variant of syringoma. Three adult female patients (age range 39–76 years old) were found to have multiple, flesh-colored lower eyelid papules, clinically consistent with syringomas, but histologically displaying abundant clear cell change. Two patients had known diagnoses of uncontrolled diabetes.
The Natural History of Primary Inner Ear Schwannomas: Outcomes of Long-Term Follow-Up
Authors: Khera Zain , Kay-Rivest Emily , Friedmann David R. , McMenomey Sean O. , Thomas Roland J. , Jethanamest Daniel
Published: September 2022

Objective

To describe the natural history of primary inner ear schwannomas over a long follow-up period.

Study design

Retrospective case series.

Setting

Tertiary referral center.

Patients

Patients with primary inner ear schwannomas with serial audiometric and radiologic follow-up.

Main Outcome Measure(s)

Patterns of hearing loss, rate of hearing decline, presence of vestibular symptoms, and rate of tumor growth.

Results

A total of 12 patients with 13 tumors were identified. The mean duration of follow-up was 7 years. Forty-six percent of tumors were intracochlear, 15% were intravestibular, 23% were transmodiolar, and 15% were intravestibular-cochlear. Hearing loss was the most common presenting symptom, occurring in all patients. Among patients with serviceable hearing (American Academy of Otolaryngology-Head and Neck Surgery Class A or B) at the time of presentation, the average time to decline to a nonserviceable hearing level was 57.3 months (range, 21–117 mo). Hearing loss was sudden in 31% of patients, progressive in 61% and fluctuating in 8%. No patients had intractable vertigo; however, two required vestibular physiotherapy. On initial magnetic resonance imaging, the mean largest tumor dimension was 3.1 mm (standard deviation, 1.2 mm), and the mean largest dimension on most recent magnetic resonance imaging was 4.4 mm (standard deviation, 1.1 mm). Two tumors exhibited no growth over a follow-up of 11.3 and 2.8 years, respectively. Overall, the mean growth was 0.25 mm per year followed. Two patients underwent cochlear implantation with simultaneous tumor resection and had favorable outcomes.

Conclusion

Long-term follow-up suggests a conservative approach, with possible hearing rehabilitation at the time of deterioration, is a safe management strategy for primary inner ear schwannomas.
Using a 3-Phase Peer Feedback to Enhance Nursing Students' Reflective Abilities, Clinical Competencies, Feedback Practices, and Sense of Empowerment
Authors: Zhang Hui , Yoong Si Qi , Dong Yan Hong , Goh Sam Hongli , Lim Siriwan , Chan Yah Shih , Wang Wenru , Wu Xi Vivien
Published: September 2022

Background:

Peer feedback (PF) has attracted much attention in health profession education with growing evidence on its benefits. However, it lacks a proper framework to guide its operation, which raises concerns about its quality in nursing education.

Purpose:

To compare the effects of a 3-phase PF versus faculty feedback (FF) on students' reflective abilities and clinical competencies after simulated practice, and its impacts on peer tutors' feedback practices and empowerment level.

Methods:

This study used a 3-arm pretest-posttest quasi-experimental methodology.

Results:

Peer verbal feedback significantly increased students' reflective abilities and clinical competencies, while peer video feedback significantly increased clinical competencies. However, FF outcomes did not reach significance. Peer tutors' empowerment level did not significantly improve, but feedback practices were perceived as comparable with FF.

Conclusions:

Peer feedback can potentially improve students' reflective abilities and clinical competencies. Proper feedback training with a structured framework will likely enhance peer tutors' feedback practices.
Nursing Students' Use of Harm Reduction in the Clinical Setting
Authors: Dion Kimberly , Choi Jeungok , Griggs Stephanie
Published: September 2022

Background:

The use and awareness of harm reduction education strategies are missing from nursing care of people with substance use disorder (SUD).

Purpose:

To determine whether targeted training improved nursing students' application of harm reduction education in the clinical setting.

Methods:

This was an experimental 2-group repeated-measures survey study. Nursing students in a baccalaureate program received targeted training for 3 semesters. Training included presentations by people with lived experience, an addiction-trained physician, and a role-play exercise. Students received harm reduction education and reported on the application of this education.

Results:

Students in the traditional track cared for more people with SUD than students in the accelerated track. Referral for treatment was the most common education provided, and information related to injection drug use was the least commonly taught education.

Conclusions:

Targeted training increased the number of harm reduction options nursing students presented to people with SUD in the clinical setting.
Organoids as a model to study the human endometrium
Authors: Li Jian-Lin , Lin Le-Qian , Zhong Jiang-Ming , Li Xin-Tong , Lee Cheuk-Lun , Chiu Philip C.N.
Published: September 2022

The endometrium is composed of glandular and luminal epithelia supported by stromal connective tissue and multiple other cell types. It is a dynamic organ that undergoes physiological and functional alteration during the menstrual cycle. Organoids resemble the primary tissue of origin to recapitulate their corresponding biological and pathological characteristics. They are known for their ability to undergo extensive expansion while maintaining their genomic stability, facilitating their long-term storage and high-throughput screening. The development of the three-dimensional endometrial organoid system, which recapitulates the structural and functional characteristics of the endometrial glands, provides a powerful tool to study the normal endometrium and its related diseases. The Web of Science was searched for relevant literature using the keywords “endometrium,” “endometrial gland,” “organoid,” and “culture model”; a total of 134 articles were selected. In this review, the characteristics, applications, and limitations of endometrial epithelial organoids are discussed.
Evaluating chromosomal segregation in a family where both spouses carry an autosomal translocation
Authors: Puppo Irina L. , Tonyan Ziravard N. , Saifitdinova Alsu F. , Loginova Julia A. , Kinunen Anna A. , Panina Alisa N. , Pastuhova Julia R. , Leonteva Olga A. , Chiryaeva Olga G. , Malysheva Olga V. , Glotov Oleg S. , Poliakova Irina V. , Tikhonov Andrey V. , Vavilova Tatyana V. , Menshikova Irina L. , Isakova Elvira V. , Glotov Andrey S. , Bichevaya Natalya K.
Published: September 2022

Autosomal reciprocal translocations represent exchanges of chromatin fragments between non-homologous chromosomes. Translocations are facilitated by the creation of quadrivalent structures during the first meiotic division, which are characterized by the length of the translocated and centric segments, asymmetry, and the presence of terminal breakpoints, all of which may impact segregation mode. Here, we report a rare case of multiple reciprocal translocations within a single family. This includes the evaluation of the translocations in each of the spouses and an analysis of their chromosome segregation patterns as determined by the constellation of universal characteristics in each of their quadrivalents. The obtained results will be of interest to fundamental biology, as they will expand the understanding of the factors affecting chromosome segregation during meiosis.
Blastocyst-like embryo surrogates from stem cells in implantation models
Authors: Tian Si-Yu , Ruan Han-Zhang , Yeung William Shu Biu , Lee Yin Lau
Published: September 2022

Successful embryo implantation requires highly coordinated maternal-embryo interactions. Implantation failure is a major factor contributing to infertility. However, the mechanism underlying implantation failure remains unclear. An improved understanding of the early implantation process not only improves the success rate of assisted reproductive treatments, but also helps in studying the pathophysiology of reproductive disorders. Owing to ethical concerns, in vivo studies of human embryo implantation are not feasible. However, the results obtained from animal models cannot be directly applied to humans. Over the years, in vitro implantation models have been developed to investigate implantation mechanisms. In this review, we discuss the use of different models for generating embryo-like surrogates to study early embryo development and implantation in vitro, with a specific focus on stem cell-derived blastocyst-like embryo surrogates. There is no definitive evidence that the recently established embryo-like models recapitulate all developmental events of human embryos during the peri-implantation stage. Regardless, stem cell-derived embryo surrogates are the most valuable tools for studying the mechanisms of early cell lineage differentiation and developmental failures during implantation.
Right Kidney Position for Laparoscopic Liver Resection of Tumors Located in the Posterosuperior Region
Authors: Notake Tsuyoshi , Shimizu Akira , Kubota Koji , Sugenoya Shinsuke , Hosoda Kiyotaka , Hayashi Hikaru , Yasukawa Koya , Umemura Kentaro , Kobayashi Ryoichiro , Soejima Yuji
Published: September 2022

Background:

Laparoscopic liver resection (LLR) for tumors located in posterosuperior (PS) region of the liver (segment 7 or 8) is extremely challenging. Several techniques have been proposed; however, no standard procedure has yet been established. The aim of this study was to present and discuss the usefulness of the right kidney position as a unique idea of surgical position in LLR for tumors located in the PS region.

Materials and Methods:

For the right kidney position, the patient lay on the operating table in the left lateral decubitus position with the body bent so that the kidney rest (approximately the level of the twelfth rib) was elevated to extend the surgical area. The surgeon was positioned on the right or left side of the patient according to the situation during operation. An intercostal port was not used in any of the cases. The operating table was liberally rotated as per the surgeon’s preference. The liver was mobilized by dividing the right triangular and coronary ligaments. Full mobilization of the right liver was not routinely performed. Liver transection was performed under intermittent inflow occlusion in all cases.

Results:

Thirteen patients with tumors located in the PS region underwent LLR in the right kidney position at Shinshu University Hospital between June 2019 and May 2021. Of the 13 patients, 11 patients underwent limited liver resection and two underwent anatomic liver resection of segment 8. The right kidney position enables the surgeon to secure a wider surgical field under the dome and prevent the camera and forceps from hitting the ilium and interfering with the operation, and the surgical device can easily reach the lesion under the dome because of the migration to the caudal side of the liver. No patients required blood transfusion or conversion to open liver resection. The median surgical margin was 6 mm (range 0 to 9 mm).

Conclusions:

The right kidney position is useful, especially for the resection of tumors located in the PS region of the liver.