bluuebunny/crossref_metadata_2025 huggingface dataset:
The Corpus Reformatorum and Other Major Editing Projects
Authors: Purvis Zachary
Published: June 2023

In the nineteenth century, scholars across Europe produced massive critical editions of texts from the history of Christianity in large volumes that number in the hundreds. This chapter overviews some of the religio-political circumstances that led to the creation of the greatest edition in German theology: the Corpus Reformatorum. Planned by Karl Gottlieb Bretschneider, the rationalist superintendent in Saxe-Gotha, printed by Carl August Schwetschke in Halle, and launched in 1834, the project entailed collecting, emending, and publishing everything extant written down by major sixteenth-century Protestant reformers: Philip Melanchthon, John Calvin, Huldrych Zwingli, Martin Luther, and more. The Prussian king, Friedrich Wilhelm III, and Minister of Culture, Karl von Altenstein, supported it as a means of investing the Prussian Union Church—the merger of Lutheran and Calvinist churches from 1817—with an extravagant history and tradition and as a monument to critical German scholarship (Wissenschaft). The work demanded technical skill and innovation. Its influence in modern ecclesiastical history remains deep and profound.
The British Army
Authors: Beckett Ian F. W.
Published: June 2023

This new history brings together in a single volume past scholarship and the most recent research on the British army and its relationship with state and society from its origins to the present. The constitutional, administrative, political, and military development of the army is set within its international, imperial, national, regional, and local contexts. Such themes as military professionalism, civil–military relations, the army’s largely unrepresentative social composition, contrasting strategic views, and the army’s image and identity all find their place alongside wars and campaigns. The story is followed from the origins of the first standing army in the seventeenth century, to the national army of the eighteenth century, the imperial army of the nineteenth century, the people’s army of the twentieth century, through to the contemporary aspiration for a continuing global role for the army amid the challenges of changing strategic priorities, changing social and cultural environments, and continuing financial pressures.
The ECB and Financial Stability
Authors: Smoleńska Agnieszka , Beukers Thomas
Published: June 2023

This chapter analyses the extent to which financial stability is or has since the Global Financial Crisis and the following euro area sovereign debt crisis, become part of the mandate of the European Central Bank (ECB), both in law and in practice. Drawing on economic and institutional discussions and legal scholarship on Economic and Monetary Union concerning financial stability, the chapter points to the lack of clarity as to the precise meaning of this term. It is argued that going beyond the content of the Treaty articles and taking a closer look at the operation of the ECB provides a more accurate picture of the role that financial stability plays in the implementation of its mandate. An analysis of various central bank instruments identified by Tomasso Padoa-Schioppa is offered in order to draw out the ways in which the concept is deployed, and to illustrate how financial stability is relevant in the context of, for example, the monetary policy strategy, crisis coordination, or payment system operation. The chapter illustrates the many different relevant dimensions and aspects of the objective of financial stability in general, and of financial stability instruments in the law and practice of the ECB in particular.
The ECB and Economic Integration
Authors: Bauerschmidt Jonathan
Published: June 2023

This chapter explores the expansive force of monetary policy and how it collides with neighbouring policy areas which apply to all the Member States of the Union, creating tensions for which the EU Treaties are ill equipped. The European Central Bank (ECB) as the main actor of monetary policy is at the centre of these evolutions. By analysing the central bank’s involvement in areas beyond monetary policy, the chapter not only uncovers the tensions with neighbouring policies, but also assesses whether the ECB’s independence and its primary objective of price stability are safeguarded. The chapter focuses on the one hand on the measures to promote budgetary stability to enhance economic policy coordination and to establish a permanent mechanism for financial assistance. On the other hand, it analyses the new forms of supervision for the internal market in order to safeguard financial stability. This chapter finally seeks to reveal the cunning of European Integration and how under the Treaties economics and politics are intrinsically connected creating strong incentives to stand together in the face of even severe crises.
The ECB Mandate—a Comparative Constitutional Perspective
Authors: Petit Christy Ann
Published: June 2023

This chapter provides a comparative constitutional analysis of the European Central Bank (ECB)’s mandate with a view to understanding the role undertaken by this and several other important central banks during and after the Great Financial Crisis (GFC). It discusses the relationship between a central bank’s mandate, its objectives, and tasks, in law and in action. Moreover, it gives an overview of both the formal mandate of the ECB, the FED, the Bank of Canada, and the Bank of England, and how these formal mandates have been implemented. Statutory sources remained mostly unchanged whereas policy actions have reshaped the practical scope of central bank mandates. Monetary policy strategy implements central bank mandates through extra-statutory sources, taking advantage of the flexibility granted to the central bank by their frameworks. The common analytical grid of single versus dual mandate may be revisited, giving full credit to a different macroeconomic environment and interactions with other public policies.
The Role of Constitutional Law for the ECB
Authors: Sluis Marijn van der
Published: June 2023

This chapter examines the evolution of the constitutional design of the Economic and Monetary Union (EMU) as it was defined in the Maastricht Treaty and rebuts the common assumption that it has proven to be a failure. Indeed, this chapter posits that the Maastricht Treaty set both economic and political goals, and by including those defining provisions in primary law, Member States made sure that they—and not the EU institutions— remained in charge. Thus, despite the fact that the euro area crisis has led to significant innovations in the day-to-day governance of EMU, the constitutional environment in which the European Central Bank (ECB) operates has not significantly changed. The chapter argues in conclusion that the euro and the ECB must be de-constitutionalized.
The ECB’s E-ROAD Ahead
Authors: Smits René
Published: June 2023

This final contribution takes a more critical, forward-looking stance than the other chapters included in this edited volume. It underlines five developments, which, in the author’s opinion, lead to the conclusion that today’s European Central Bank (ECB) operates in an environment that is radically different from the one in which it was established in 1998. This chapter argues that four main changes have occurred that represent both threats and opportunities for the future of the ECB: threats to democracy, technological developments, the COVID-19 pandemic, and climate change and biodiversity loss. The ECB should, then, Reform, Open Up, Address, and Develop to address them and become (or continue to be) a main actor within the EU. In addition, societal challenges, including the call for greater economic equality and inclusion and the need for transparency and responsiveness as an organization are facing the ECB.
Kant’s Theoretical Defense of Moral Freedom
Authors: Kohl Markus
Published: June 2023

This chapter considers the lingering worry that remained after the preceding chapter: namely, the concern that practical reason oversteps its legitimate boundaries when it posits free moral agents as the specific noumenal causes of natural events. The chapter shows that Kant is aware of this worry: he addresses theoretical attempts to “naturalize” morality, i.e., to conceive our practical reason and will as a part of the natural order of things. Such attempts are fueled by the aim to preserve the “omnipotence of theoretical reason.” Kant defends the non-natural character of morality and (thereby) our knowledge of noumenal free will by arguing that those who seek to cognize the natural order of things must presuppose their own non-natural (a priori) theoretical representations and their freedom of thought. Since freedom of thought as a species of transcendental freedom is analogous to freedom of will, naturalistic cognizers cannot coherently debunk or explain away our a priori moral self-consciousness as free agents. This appeal to freedom of thought functions not as an independent proof of free will but as a theoretical defense of the practical-moral proof examined in Chapter VIII. The chapter confirms the potency of this defense strategy by showing how it applies to Nietzschean attempts to debunk our moral self-awareness. The chapter further shows how Kant’s defense of absolute human freedom avoids the worry that such freedom is incompatible with divine foreknowledge of human actions.
Introduction
Authors: Wedgwood Ralph
Published: June 2023

This is the Introduction to the book—the goal of which it is to present a general theory of rational belief. This book is a sequel to the author’s previous book, The Value of Rationality (Oxford University Press, 2017). It aims to take the general conception of rationality that was developed in that earlier book, and to combine this conception with an account of the nature of belief, to yield an account of what it is for beliefs to count as rational. The central idea of this general conception of rationality is that rational thinking gives the thinker “good news” about this thinking’s degree of correctness—while the more irrational one’s thinking is, the worse the news that it gives one about its degree of correctness. A brief account is given of some of the epistemological questions that the book is designed to address. Then, after some comments on the methodological issues that any book on this subject must confront, the overall plan of the book is outlined. Finally, some of the limits of this project are discussed: in particular, despite the enormous importance of social epistemology, the focus of this book will be on what it is for an individual’s beliefs to count as rational.
The Value of Rational Belief
Authors: Wedgwood Ralph
Published: June 2023

Chapter 1 recapitulates the key ideas of the author’s previous book The Value of Rationality. The central idea is that rationality is an evaluative concept: rational thinking is thinking that is good in a certain respect; and the more irrational one’s thinking is, the worse one’s thinking is in that respect. The various belief-systems available to a thinker at a time can be compared as more or less rational than each other, on the basis of how they relate to certain facts that are “given” to the thinker at the time—that is, facts that are beyond the control of the thinker to change through the way in which she reasons at the time. Specifically, a kind of internalism holds of the relevant facts that are “given”: the facts that determine the degree to which an available belief-system is rational for a thinker at a time are all “internal” facts about the thinker’s mental states at that time. However, rationality is not a completely free-standing value: it has an essential connection to another value—the value of “correctness”, which unlike rationality is an “externalist” value. The general idea is that irrational thinking is thinking that gives one “bad news” about how correct it is. This idea of “bad news” is to be understood in probabilistic terms.
Diachronic Constraints
Authors: Wedgwood Ralph
Published: June 2023

Chapter 13 turns to diachronic constraints on the rational probability function—constraints that the thinker’s past beliefs impose on which probability functions can be in the set that represents the opinions of the “evaluating angel”. Some philosophers—such as Brian Hedden—object that the idea of such diachronic constraints is inconsistent with internalism about rationality. These objections are answered here. It seems clear that the past continues to exert an influence over the present. This lingering influence of the thinker’s past beliefs will be referred to as the “doxastic shadow” that those past beliefs cast into the present. The angel will be guided by this shadow in the following way: first, she will find the “shadow priors”—the probability functions that, of all those that meet all the synchronic constraints, are closest to this doxastic shadow. Then the probability functions that constitute the angel’s opinions are those that result from conditionalizing these shadow priors on the facts that are “given” to the thinker now. This chapter ends with a proposal about what explains why this view of diachronic rationality is correct.
The Palatine Family and the Thirty Years' War
Authors: Pert Thomas
Published: June 2023

This work examines the experience of exiled royal and noble dynasties during the early modern period through a study of the rulers of the Electorate of the Palatinate during the Thirty Years’ War (1618–1648). By drawing on a wide range of archival source materials, ranging from financial records, printed manifestos, and considerable quantities of diplomatic and personal correspondence, the book investigates the resources available to the exiled ‘Palatine Family’ as well as their attempts to recover the lands and titles lost by Elector Frederick V—the son-in-law of King James VI and I of Scotland and England—in the opening stages of the Thirty Years’ War. This work focuses on the years between Frederick’s death in 1632 and the partial restoration of his son Charles Louis under the Peace of Westphalia in 1648. Although the ‘Palatine Question’ remained one of the most divisive and important issues throughout the entire Thirty Years’ War, the years 1632–1648 have been greatly overlooked in previous examinations of the Palatine Family’s exile. By studying the experiences of exiled elites in early modern Europe—such as the relationship between the Palatine Family and the Stuart Dynasty—this work will reveal the influence of dynastic and familial obligations on the high politics of the period, as well as the importance of conspicuous display and diplomatic recognition for exiled regimes in seventeenth-century Europe. The work will demonstrate that dispossessed rulers and houses were not automatically rendered politically insignificant after losing their lands and titles, and could actually remain an important player on the geopolitical stage of early modern Europe.
Introduction
Authors: Pert Thomas
Published: June 2023

This chapter introduces the main themes and topics of the book, ranging from the experiences of exile for rulers in early modern Europe to the importance of factors such as dynasticism in the high politics of the period as well as the role of ‘widow-regents’ during the Thirty Years’ War. The chapter also provides an overview of the existing historiography relating to the ‘Palatine Family’ and identifies the gaps in the current scholarship which will be filled by this book. The final section of this chapter details the structure of the book, providing brief summaries of each of the subsequent chapters.
Corruption and Global Injustice
Authors: Brock Gillian
Published: June 2023

The chapter shows how corruption plays an enormous role in sustaining global injustice and hinders efforts aimed at remedying global deprivation. One of the greatest obstacles to wellbeing in developing countries is a lack of clean water, resulting in many avoidable deaths every day. Water and sanitation services are also vital for sustainable pro-poor development. Around 32 percent of the world’s population lacks access to safe drinking water and basic sanitation. Although billions of dollars are spent on developing water resources and services, a large amount of this investment is lost to corruption every year. After tracing how corruption in the water sector exacerbates global deprivation, the chapter outlines key parts of Brock’s global justice framework, to appreciate how to target corruption-facilitating features. The combination of effective states and civic participation plays an especially important part in the quest to reduce global injustices of several kinds, including corruption. The efforts of local actors are particularly important and international agents can strengthen these in several ways. As we come to understand with the case of corruption in the water sector, specific details can be extremely useful in analyzing how to assign responsibilities fairly. This is the focus of later chapters, especially Chapter 7. Chapter 2 begins to assemble the normative tools needed for the larger project. Chapter 2 emphasizes the important role domestic actors must play in addressing corruption, and Chapter 3 focuses on the complementary roles for international agents, especially in supporting these domestic actors.
Justice, State Responsibilities, and Human Rights
Authors: Brock Gillian
Published: June 2023

Chapter 3 explores some important responsibilities for states and the connections between justice and human rights discourse. The chapter begins by taking readers on a purposeful journey that challenges two core sets of assumptions that underlie our state system. In searching for a compelling justification for state’s rights to self-determination and common assumptions about compatriot favoritism, we see that the justification must include requirements to contribute to resilient communities that are human rights sustaining. Obligations to contribute to global arrangements that are human rights sustaining must feature in any credible justification for why state’s self-determination has standing. The chapter also argues that our human rights practice is an attractive normative vehicle for realizing justice goals here and now. Another important theme from Chapter 3 is that combating corruption and realizing human rights are intimately connected and mutually reinforcing. This chapter also provides defense for the claim that we have obligations to support aspects of our human rights practice that are credible mechanisms for implementing justice. To assess whether our human rights practice delivers on the promise in the case of corruption, we examine core features of that practice with regard to corruption. Chapter 5 focuses on that issue and, as an important part of that assessment, Chapter 4 canvases research on addressing corruption effectively.
Taking Raz Seriously
Authors: Penner James
Published: June 2023

This chapter raises some general considerations about the relevance of Raz’s theory of autonomy to private law. It argues that Raz’s theory of autonomy meshes pretty seamlessly with what might be called a “Kantian instrumentalist” account of private law, pointing out an aspect of his theory which has arguably not been given sufficient attention, that is, the “independence” condition for autonomy. Reasons are then provided for proceeding with caution if we aim to show that private law gives effect to the “range of options” condition for autonomy Raz identifies. The final part of the chapter turns to Dagan’s and Heller’s conception of autonomy, distinguishes it from Raz’s, and raises some questions about its nature and effectiveness in explaining private law.
The Role of Democracy in Private Law
Authors: Rosen Arie
Published: June 2023

Meaningfully democratic legislation in private law—legislation whose content is shaped by processes of election, deliberation, and majority vote—is relatively rare. Even when such legislation does occur, it ordinarily takes the shape of circumscribed interventions on particular kinds of property or certain types of voluntary and involuntary transactions, leaving the core set of general private law rules and principles beyond democratic scrutiny. This chapter sets out to trace and evaluate this bifurcated structure characteristic of the making of modern private law. Eschewing traditional generalizations about legislation and judge-made law, it offers a typology of legislative processes that clarifies the fault lines between democratic and professional lawmaking. It then considers the case for the radical democratization of private law and explains why, given the normative complexity of private law, a bifurcated process for generating it can be defended even by those committed to democratic lawmaking.
Social Movements
Authors: Rucht Dieter
Published: June 2023

This treatise offers a theoretically informed approach to social movements as a phenomenon of modern societies. It combines three basic perspectives: interactionist, constructivist, and process-oriented (ICP-approach). The overall ambition is to link the analysis of social movements to general theories of society and processes of social change. To this aim, the treatise mainly draws on ideas from Jürgen Habermas, Pierre Bourdieu, and Anthony Giddens. Several revisions are recommended with regard to Habermas’ theory of communicative action; one of these is to recognize the importance of the public sphere as a realm in its own right beyond functional systems (such as the economy and the political-administrative system) and the daily lifeworld. The public sphere is the major domain in which social movements make themselves seen and heard, garner support, and possibly succeed in changing basic societal structures. The treatise argues that properly defined social movements only emerged in modern times. The book covers a large ground, analyzing the external and internal activities of social movements, the role of different kinds of opportunities and restrictions, collective identities and framing, organizing, networking, and strategizing. It parses the complexity of social movements that have a status as both actors and systems, and whose logic cannot be reduced to either strategic or communicative action.
Anticommunism in French Politics and Society, 1945–1953
Authors: Clift Aaron
Published: June 2023

This chapter contextualizes anticommunism in the postwar French political, social, and economic environment. It discusses the strength and character of French communism, to which anticommunists responded. Furthermore, it outlines some of the major issues which structured reactions to communism and anticommunism, including postwar economic and social reconstruction, the politics of the Fourth Republic; the legacies of the Second World War, decolonization, anti-Americanism, religious developments, and gender. Throughout, the chapter discusses how previous historians have addressed these topics and how they relate to anticommunism.
L’Affaire Bertier
Authors: Clift Aaron
Published: June 2023

This chapter looks at anticommunism within the French scouting movement. Youth movements and education were inevitably arenas for political debate as rival forces battled to influence the values of the next generation. The scouts, as the largest youth movement in France, were no exception. The postwar period saw conflict over the place of communism and anticommunism in the movement in ‘l’affaire Bertier’, in which an ex-leader accused his former organization of having been infiltrated by communists. This incident illuminates connections between anticommunism and anxieties concerning patriotism, imperialism, gender, and urbanization, as well as the roles of religion and experiences of the Second World War in structuring reactions to communism and anticommunism.
Nobeyama 45 m CO J = 1–0 observations of luminous type 1 AGNs at z ≈ 0.3
Authors: Michiyama Tomonari , Zhuang Ming-Yang , Shangguan Jinyi , Yesuf Hassen M , Kaneko Hiroyuki , Ho Luis C
Published: June 2023

We have performed CO J = 1–0 observations of 10 galaxies hosting luminous (Lbol > 1046 erg s−1) type 1 active galactic nuclei (AGNs) with the Nobeyama 45 m radio telescope. The targets are selected because they are expected to be rich in molecular gas based on their high nebular dust extinction (AV). However, no significant CO emission lines were detected in any of the targets. The upper limits of the CO J = 1–0 luminosities are lower than expected given the molecular gas mass inferred from the nebular AV. This inconsistency may be due to overestimated AV values due to the lack of stellar absorption correction. Considering more reliable AV values, the CO J = 1–0 non-detections by Nobeyama 45 m are natural. This suggests that our results do not contradict the conversion methods from AV to molecular gas mass proposed in the literature. This survey suggests that careful AV measurements as well as CO observations are still needed to improve the measurements or estimates of the molecular gas content of galaxies hosting luminous AGNs.
MYB-bHLH-TTG1 in a Multi-tiered Pathway Regulates Arabidopsis Seed Coat Mucilage Biosynthesis Genes Including PECTIN METHYLESTERASE INHIBITOR14 Required for Homogalacturonan Demethylesterification
Authors: Allen Patrick J , Napoli Ross S , Parish Roger W , Li Song Feng
Published: June 2023

MYB-bHLH-TTG1 (MBW) transcription factor (TF) complexes regulate Arabidopsis seed coat biosynthesis pathways via a multi-tiered regulatory mechanism. The MYB genes include MYB5, MYB23 and TRANSPARENT TESTA2 (TT2), which regulate GLABRA2 (GL2), HOMEODOMAIN GLABROUS2 (HDG2) and TRANSPARENT TESTA GLABRA2 (TTG2). Here, we examine the role of PECTIN METHYLESTERASE INHIBITOR14 (PMEI14) in seed coat mucilage pectin methylesterification and provide evidence in support of multi-tiered regulation of seed coat mucilage biosynthesis genes including PMEI14. The PMEI14 promoter was active in the seed coat and developing embryo. A pmei14 mutant exhibited stronger attachment of the outer layer of seed coat mucilage, increased mucilage homogalacturonan demethylesterification and reduced seed coat radial cell wall thickness, results consistent with decreased PMEI activity giving rise to increased PME activity. Reduced mucilage release from the seeds of myb5, myb23, tt2 and gl2, hdg2, ttg2 triple mutants indicated that HDG2 and MYB23 play minor roles in seed coat mucilage deposition. Chromatin immunoprecipitation analysis found that MYB5, TT8 and seven mucilage pathway structural genes are directly regulated by MYB5. Expression levels of GL2, HDG2, TTG2 and nine mucilage biosynthesis genes including PMEI14 in the combinatorial mutant seeds indicated that these genes are positively regulated by at least two of those six TFs and that TTG1 and TTG2 are major regulators of PMEI14 expression. Our results show that MYB-bHLH-TTG1 complexes regulate mucilage biosynthesis genes, including PMEI14, both directly and indirectly via a three-tiered mechanism involving GL2, HDG2 and TTG2.
Speaking good to power: repositioning global policy advice through normative framing
Authors: Pal Leslie A
Published: June 2023

The delegitimization of policy advice has generated a defensive response that combines an assertion of the superior scientific character of expertise with a forthright affirmation of social and political values. This more value-driven discourse of policy expertise is examined with the case study of the Global Solutions Summit/World Policy Forum, launched in 2017 to support the Think20 network of global policy advisors supporting the G20 meetings under the German presidency. The Global Solutions Summit has evolved into a more policy-wonkish version of the World Economic Forum held annually in Davos and now is a switching point of global policy advice for the G7 as well. Through participant observation and an analysis of the proceedings of the annual summits since 2017, the article shows a distinctive configuration of normatively framed policy advice designed to overcome the social and political pathologies that have been the foundation of populist critiques of policy expertise.
Higgs portal majorana fermionic dark matter with the freeze-in mechanism
Authors: Ikemoto Junpei , Haba Naoyuki , Yasuhiro Shimizu , Yamada Toshifumi
Published: June 2023

We consider a minimal model of fermionic dark matter (DM), in which the Majorana fermion DM χ couples with the Standard Model (SM) Higgs field H through a higher-dimensional term $-{\cal L}\supset H^\dagger H \bar{\chi }\chi /\Lambda$, where Λ is the cutoff scale. We assume that Λ is sufficiently large that DM particles are not in thermal equilibrium with the SM particles throughout the history of the universe. Hence, DM particles are produced only by the freeze-in mechanism. Through a numerical analysis of the freeze-in mechanism, we show contour plots of the DM relic abundance for various values of the DM mass, reheating temperature, and the cutoff scale. We obtain an upper bound of the DM mass and cutoff scale from contour plots on the (mχ, Λ)-plane. We also consider direct DM detection for the parameter regions where the DM relic abundance is consistent with the experimental values. We find that the spin-independent cross section for the elastic scattering with a nucleon is below the current experimental upper bound.
Scalar polarization window in gravitational-wave signals
Authors: Takeda Hiroki , Manita Yusuke , Omiya Hidetoshi , Tanaka Takahiro
Published: June 2023

Scalar polarization modes of gravitational waves, which are often introduced in the context of the viable extension of gravity, have been actively searched for. However, couplings of the scalar modes to matter are strongly constrained by fifth-force experiments. Thus, the amplitude of scalar polarization in the observed gravitational-wave signal must be significantly suppressed compared to that of the tensor modes. Here, we discuss the implications of the experiments in the solar system on the detectability of scalar modes in gravitational waves from compact binary coalescences, taking into account the whole processes from the generation to the observation of gravitational waves. We first claim that the energy carried by the scalar modes at the generation is, at most, that of the tensor modes from the observed phase evolution of the inspiral gravitational waves. Next, we formulate general gravitational-wave propagation and point out that the energy flux hardly changes through propagation as long as the background changes slowly compared to the wavelength of the propagating waves. Finally, we show that the possible magnitude of scalar polarization modes detected by ground-based gravitational-wave telescopes is already severely constrained by the existing gravity tests in the solar system.
Patient exposure during videofluoroscopic swallowing studies performed by speech-language pathologists
Authors: Tsalafoutas Ioannis A , AlKhazzam Shady , Hussain Mohammed S , Omar Ahmed J , Bawazir Salwa S , AlHamad Suad A , AlNaemi Huda , Kharita Mohammad H
Published: June 2023

Videofluoroscopic swallowing studies (VFSSs) are fluoroscopic examinations performed by speech and language pathologists (SLPs), for the evaluation of the oral and pharyngeal phases of swallowing, in patients who are diagnosed with symptoms like dysphagia and speech impairment. The study was focused on the evaluation of the patient doses from VFSS performed at Hamad Medical Corporation hospitals. Data on the patient exposure and examination parameters were extracted from the Radiation Dose Monitoring system, statistically analysed and compared with literature. For adult patients, the mean (median) values for fluoroscopy time and kerma-air product were 2.8 (2.7) min and 181 (144) cGycm2, respectively. For children, the respective mean (median) values were 2.6 (2.4) min and 15.3 (9.2) cGycm2. The results of the study indicate that the VFSS are performed by well-trained health professionals, and as a result, image quality sufficient for a confident diagnosis is obtained at relatively low dose levels.
The family web: Multigenerational class persistence in elite populations
Authors: O’Brien Shay
Published: June 2023

This article introduces the first-ever full kinship network of an upper-class population in a US city (n = 12 273). Multigenerational class transmission models tend to conceptualize families as father–son chains, especially for the upper class, but I systematically include women, finding that nearly 70% of Dallas high society from 1895 to 1945 was related in a single web encompassing most of the city’s wealthy, powerful, and high-status people. Because elites did not always have sons, nearly three times more families persisted over the 50-year period than patrilineal measures would suggest. Almost all persistent families connected to the web, and they connected more deeply than non-persistent families. Three case studies demonstrate that women and kin ties beyond the patrilineage frequently drove elite family persistence. Upper-class populations are best understood not as collections of distinct dynasties that live or die with the success of sons, but as complex, durable family webs.
Intraoperative Methadone in Next-day Discharge Outpatient Surgery: A Randomized, Double-blinded, Dose-finding Pilot Study
Authors: Kharasch Evan D. , Brunt L. Michael , Blood Jane , Komen Helga
Published: June 2023

Background

Contemporary perioperative practice seeks to use less intraoperative opioid, diminish postoperative pain and opioid use, and enable less postdischarge opioid prescribing. For inpatient surgery, anesthesia with intraoperative methadone, compared with short-duration opioids, results in less pain, less postoperative opioid use, and greater patient satisfaction. This pilot investigation aimed to determine single-dose intraoperative methadone feasibility for next-day discharge outpatient surgery, determine an optimally analgesic and well-tolerated dose, and explore whether methadone would result in less postoperative opioid use compared with conventional short-duration opioids.

Methods

This double-blind, randomized, dose-escalation feasibility and pilot study in next-day discharge surgery compared intraoperative single-dose IV methadone (0.1 then 0.2, 0.25 and 0.3 mg/kg ideal body weight) versus as-needed short-duration opioid (fentanyl, hydromorphone) controls. Perioperative opioid use, pain, and side effects were assessed before discharge. Patients recorded pain, opioid use, and side effects for 30 days postoperatively using take-home diaries. Primary clinical outcome was in-hospital (intraoperative and postoperative) opioid use. Secondary outcomes were 30-day opioid consumption, pain, opioid side effects, and leftover opioid counts.

Results

Median (interquartile range) intraoperative methadone doses were 6 (5 to 7), 11 (10 to 12), 14 (13 to 16), and 18 (15 to 19) mg in 0.1, 0.2, 0.25, and 0.3 mg/kg ideal body weight groups, respectively. Anesthesia with single-dose methadone and propofol or volatile anesthetic was effective. Total in-hospital opioid use (IV milligram morphine equivalents [MME]) was 25 (20 to 37), 20 (13 to 30), 27 (18 to 32), and 25 (20 to 36) mg, respectively, in patients receiving 0.1, 0.2, 0.25 and 0.3 mg/kg methadone, compared to 46 (33 to 59) mg in short-duration opioid controls. Opioid-related side effects were not numerically different. Home pain and opioid use were numerically lower in patients receiving methadone.

Conclusions

The most effective and well-tolerated single intraoperative induction dose of methadone for next-day discharge surgery was 0.25 mg/kg ideal body weight (median, 14 mg). Single-dose intraoperative methadone was analgesic and opioid-sparing in next-day discharge outpatient surgery.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Bipolar Fusionless Versus Standard Fusion Surgery in Neuromuscular Scoliosis
Authors: Vergillos-Luna Manuel , Alhada Toulla , Oborocianu Ioana , Miladi Lotfi , Monticone Marco , Rampal Virginie , Saint-Pol Anne-Laure , Bertoncelli Carlo M. , Boissière Louis , Solla Federico
Published: June 2023

Study Design:

Nonrandomized controlled cohort.

Objective:

To compare early results between bipolar fusionless construct (BFC) and single posterior fusion (SPF) surgery in neuromuscular scoliosis (NMS).

Background:

Surgical treatments for NMS have traditionally been characterized by high complication rates. A mini-invasive BFC was developed to reduce these risks while maintaining adequate curve reduction. There is, however, a current lack of studies comparing clinical and radiologic perioperative outcomes between both techniques.

Methods:

All patients surgically treated for NMS with to-pelvis construct between 2011 and 2021 at 2 centers were included and divided into 2 groups according to the surgical technique (BFC or SPF). Gender, age, main deformity region, etiology, preoperative and postoperative main curve magnitude and pelvic obliquity, surgery time, estimated blood loss and transfusion rates, length of hospital stay, the magnitude of main curve and pelvic obliquity correction, and early complications were compared. Quantitative data were compared through ANOVA or Mann-Whitney test. Analysis of qualitative outcomes was performed through Fisher exact test and logistic regressions. Kruskal-Wallis test was used to compare complications between groups.

Results:

Eighty-nine NMS patients were included: 48 in the SPF group and 41 in the BFC group. Surgery time (203 vs. 241 min), rate (32 vs. 52%) and severity of complications, unplanned returns to the operating room (15 vs. 39%), estimated blood loss (179 vs. 364 cc), and transfusion rates (27 vs. 73%) were lower in the BFC group (P<0.05). There were no significant differences in age, maturity stage, preoperative curve magnitude, preoperative pelvic obliquity and postoperative curve, and pelvic obliquity correction between groups.

Conclusions:

BFC may be a safer and less invasive option for NMS surgical treatment, resulting in similar curve corrections while significantly decreasing the number and severity of complications as well as intraoperative blood loss when compared with SPF.

Level of evidence:

Level —lll.
Two-pin Posterior Tuberosity to Medial Wall Reduction Technique in Calcaneal Fracture Using Sinus Tarsi Approach
Authors: Sockalingam Navindravadhanam , Leow Voon Chin , Balakrishnan Theenesh T. , Eo Chun Keat , Thiruselvam Tharumaraja
Published: June 2023

Introduction:

The purpose of this study was to describe a novel technique in the surgical treatment of displaced intra-articular calcaneal fractures using 2 Schanz pins to reduce the posterior tuberosity to the medial wall (constant fragment) and correcting the varus malalignment while using the sinus tarsi approach.

Materials and Methods:

Twelve patients with calcaneal fractures Sanders type 2 and 3 underwent surgical fixation using this technique at our center from January 2021 to September 2021. One Schanz pin was inserted into the constant fragment and another one was inserted into the posterior tuberosity from lateral to medial. By holding the 2 pins the fracture fragments were first disengaged by applying a distraction force. The heel was then brought out of varus by a combination of maneuvres. The posterior calcaneal tuberosity pin was pushed medially and then the 2 pins were held together with one hand. The ankle was then dorsiflexed to lock the reduction. Harris heel views were taken to ensure reduction.

Results:

The mean Bohler angle improved from 7.5 degrees preoperatively to 29 degrees postoperatively. The mean Visual Analog Scale was 2.3 out of 10 at 6 months’ follow-up. None of the patients had wound complications, sural nerve neuropraxia, or revision surgery due to malreduction.

Discussion:

The 2-pin posterior tuberosity to medial wall reduction technique in calcaneal fractures using the sinus tarsi approach is a useful maneuver that can be used by orthopedic surgeons to correct the varus malalignment which is a frequent problem in calcaneal fracture fixation.
Alternatives to Hydrocortisone for Hemodynamic Support in Septic Shock Management Due to Medication Shortage
Authors: Aldhaeefi Mohammed , Alshaya Abdulrahman , Belrhiti Sanaa , Rungkitwattanakul Dhakrit
Published: June 2023

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Septic shock is when initial fluid resuscitation fails to increase the mean atrial pressure to greater than or equal to 65 mm Hg. The 2021 Surviving Sepsis Campaign guidelines recommend corticosteroids for vasopressor and fluid-refractory septic shock patients. Medication shortages can arise, and their etiologies include natural disasters, quality control issues, and manufacturing discontinuation. The U.S. Food and Drug Administration and the American Society of Health-System Pharmacists announced a shortage of IV hydrocortisone. Methylprednisolone and dexamethasone are considered therapeutic alternatives to hydrocortisone. This commentary aims to guide clinicians on the alternative to hydrocortisone among septic shock patients due to medication shortage.
Injury mechanism of COVID-19–induced cardiac complications
Authors: Leng Ling , Bian Xiu-Wu
Published: June 2023

Heart dysfunction is one of the most life-threatening organ dysfunctions caused by coronavirus disease 2019 (COVID-19). Myocardial or cardiovascular damage is the most common extrapulmonary organ complication in critically ill patients. Understanding the pathogenesis and pathological characteristics of myocardial and vascular injury is important for improving clinical diagnosis and treatment approach. Herein, the mechanism of direct damage caused by severe acute respiratory syndrome coronavirus 2 to the heart and secondary damage caused by virus-driven inflammation was reviewed. The pathological mechanism of ischemia and hypoxia due to microthrombosis and inflammatory injury as well as the injury mechanism of tissue inflammation and single myocardial cell necrosis triggered by the viral infection of pericytes or macrophages, hypoxia, and energy metabolism disorders were described. The latter can provide a novel diagnosis, treatment, and investigation strategy for heart dysfunctions caused by COVID-19 or the Omicron variant.
Incidental Breast Arterial Calcifications and Assessment of Coronary Artery Disease Risk: A Review and Recommendation
Authors: Koziol Klaudia J. , Frishman William H.
Published: June 2023

Coronary artery disease (CAD) continues to be the leading cause of morbidity and mortality in women, contributing to about 20%, or nearly 400,000, of female deaths annually in the United States. Despite their significant burden from CAD, women have been traditionally underrepresented in trials, and therefore, there is still much to be studied regarding the sex-based variations that have been reported regarding the pathophysiology, clinical presentation, efficacy of diagnostic workup, and response to therapy in CAD. Previous studies have reported that breast arterial calcifications, commonly found incidentally on screening mammography, may be associated with risk of CAD; however, there are currently no specific guidelines concerning reporting and quantification practices, as well as further workup recommendations for patients who are found to have vascular calcifications. Thus, the question remains whether breast arterial calcifications can serve as a sex-specific marker for CAD, and whether there is enough evidence to support the use of mammography as a screening tool for CAD in women. In this review, we will summarize the current understanding of cardiovascular disease in women, the existing literature regarding breast arterial calcifications and current reporting practices, and the association of vascular calcifications with CAD risk; based on the collected evidence, we will make a recommendation whether screening mammography and breast arterial calcifications should be used to assess CAD risk, and if so, what additional workup, if any, we recommend in women found to have breast arterial calcifications on imaging.
Clinical Application to Improve the “Depth Perception Problem” by Combining Augmented Reality and a 3D Printing Model
Authors: Katayama Misato , Mitsuno Daisuke , Ueda Koichi
Published: June 2023

Background:

In our experience with intraoperative evaluation and educational application of augmented reality technology, an illusion of depth has been a major problem. To improve this depth perception problem, we conducted two experiments combining various three-dimensional models and holograms and the observation angles using an augmented reality device.

Methods:

In experiment 1, when observing holograms projected on the surface layer of the model (bone model) or holograms projected on a layer deeper than the model (body surface model), the observer’s first impression regarding which model made it easier to understand positional relationships was investigated. In experiment 2, to achieve a more quantitative evaluation, the observer was asked to measure the distance between two specific points on the surface and deep layers from two angles in each of the above combinations. Statistical analysis was performed on the measurement error for this distance.

Results:

In experiment 1, the three-dimensional positional relationships were easier to understand in the bone than in the body surface model. In experiment 2, there was not much difference in the measurement error under either condition, which was not large enough to cause a misunderstanding of the depth relationship between the surface and deep layers.

Conclusions:

Any combination can be used for preoperative examinations and anatomical study purposes. In particular, projecting holograms on a deep model or observing positional relationships from not only the operator’s viewpoint, but also multiple other angles is more desirable because it reduces confusion caused by the depth perception problem and improves understanding of anatomy.
Addressing racial and ethnic disparities in US liver cancer care
Authors: Kim Nicole J. , Cravero Anne , VoPham Trang , Vutien Philip , Carr Rotonya , Issaka Rachel B. , Johnston Janet , McMahon Brian , Mera Jorge , Ioannou George N.
Published: June 2023

HCC, the most common form of primary liver cancer, is the fastest rising cause of cancer-related death in the United States. HCC disproportionately affects racial and ethnic minorities in the United States. A practical framework is needed to organize the complex patient, provider, health system, and societal factors that drive these racial and ethnic disparities. In this narrative review, we adapted and applied the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to the HCC care continuum, as a step toward better understanding and addressing existing HCC-related disparities. We first summarize the literature on HCC-related disparities by race and ethnicity organized by the framework’s 5 domains (biological, behavioral, physical/built environment, sociocultural environment, and health care system) and 4 levels (individual, interpersonal, community, and societal) of influence. We then offer strategies to guide future research initiatives toward promotion of health equity in HCC care. Clinicians and researchers may help mitigate further inequities and better address racial and ethnic disparities in HCC care by prioritizing the following in HCC research: (1) increasing racial and ethnic minority representation, (2) collecting and reporting HCC-related data by racial and ethnic subgroups, (3) assessing the patient experience of HCC care by race and ethnicity, and (4) evaluating HCC-specific social determinants of health by race and ethnicity. These 4 priorities will help inform the development of future programs and interventions that are tailored to the unique experiences of each racial and ethnic group.