bluuebunny/crossref_metadata_2025 huggingface dataset:
Significant Correlates of Nocturnal Hypertension in Patients With Hypertension Who Are Treated With Antihypertensive Drugs
Authors: Maruhashi Tatsuya , Kinoshita Yoshihiko , Ozono Ryoji , Nakamaru Mitsuaki , Ninomiya Masanori , Oiwa Jiro , Kawagoe Takuji , Yoshida Osamu , Matsumoto Toshiyuki , Fukunaga Yasuo , Sumii Kotaro , Ueda Hironori , Shiode Nobuo , Takahari Kosuke , Hayashi Yasuhiko , Ono Yujiro , Nakano Yukiko , Takahashi Masakazu , Kihara Yasuki , Higashi Yukihito
Published: February 2023

Background

Nocturnal hypertension assessed by a home blood pressure monitoring (HBPM) device is associated with an increased risk of cardiovascular events. However, it is still difficult to assess nighttime blood pressure (BP) frequently. The purpose of this cross-sectional study was to identify significant correlates of nocturnal hypertension assessed by an HBPM device in patients with hypertension who are treated with antihypertensive drugs.

Methods

We measured nighttime BP, morning BP, and evening BP by an HBPM device for 7 consecutive days in 365 medicated patients with hypertension.

Results

Of the 365 subjects, 138 (37.8%) had nocturnal hypertension defined as a mean nighttime systolic BP of ≥ 120 mm Hg. Receiver operating characteristic curve analyses showed that the diagnostic accuracy of morning systolic BP for subjects with nocturnal hypertension was significantly superior to that of evening systolic BP (P = 0.04) and that of office systolic BP (P < 0.001). Multivariate analysis revealed that morning systolic BP of 125–<135 mm Hg (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.13–4.58; P = 0.02), morning systolic BP of ≥ 135 mm Hg (OR, 16.4; 95% CI, 8.20–32.7; P < 0.001), and a history of cerebrovascular disease (OR, 3.99; 95% CI, 1.75–9.13; P = 0.001) were significantly associated with a higher risk of nocturnal hypertension and that bedtime dosing of antihypertensive drugs was significantly associated with a lower risk of nocturnal hypertension (OR, 0.56; 95% CI, 0.32–0.97; P = 0.04).

Conclusions

Morning systolic BP of ≥ 125 mm Hg, a history of cerebrovascular disease, and bedtime dosing were significant correlates of nocturnal hypertension in medicated patients with hypertension, and may help detect this risky BP condition.

Clinical trials registration

University Hospital Medical Information Network Clinical Trials Registry (UMIN000019173).
Melville, Insurrection, and the Problem of the Nation
Authors: Hoberek Andrew
Published: February 2023

In contrast with the standard reading of Moby-Dick (1851) as marking a turn in Melville’s writing from the realist to the symbolic, this chapter focuses on Melville’s realistic representation of insurrection in the chapter entitled “The Town-Ho’s Story.” It does so to argue that Melville understands insurrection as both central to democracy and at odds with politics organized around the nation. Moby-Dick is thus global not only in its setting, but in its formal engagement with the problem of democracy.Moby-Dick strongly suggests that Melville understands the politics of insurrection in opposition to the politics of the nation.
Odds on Erasure: The Status of the Novel on the Receding Horizon of Democracy
Authors: Esteve Mary
Published: February 2023

Literary sociology’s recent turn to contemporary publishing has brought renewed attention to Percival Everett’s acclaimed novel, Erasure (2001), which satirizes late twentieth-century media and publishing culture and raises concerns about the status of the literary novel. An episode in which literary-prize jurors cast their votes suggests the novel’s engagement with the discourse of democracy as well. This essay sets Everett’s novel in dialogue with the historian James Kloppenberg’s recent monumental study, Toward Democracy (2016). In contrast to literary sociology, which generally inflects its critical assessments with uncontroversial conceptions of democracy that rarely extend beyond egalitarian pluralism, Kloppenberg presents his work not merely as a history of centuries-long struggles with democratic practices but as a plea that we regard democracy as a conceptual and ethical horizon. Its entailments go far beyond popular sovereignty and participatory action. They include principles of autonomy and equality as well as premises of deliberation, pluralism, and reciprocity. Kloppenberg’s insistence on the relevance of these conditions dovetails with Everett’s narrative of—or implicit demand for—the relevance of aesthetic conditions that give rise to the same autonomous literary art that his fictional protagonist and Everett himself ordinarily write.[Erasure’s realism] makes visible a world populated with liberal democratic institutions that enjoy many degrees of separation from a neoliberal media and publishing world afflicted with unreality hunger.
Racial and Social Democracy in Sam Greenlee’sThe Spook Who Sat by the Door
Authors: Mitchell Justin
Published: February 2023

In 2011, Kenneth Warren boldly asserted that the collapse of Jim Crow spelled the end of African American literature. While many have sought to refute Warren on the grounds that the social conditions which originally underwrote African American literature persist in the guise of structural racism and mass incarceration, this essay focuses on Warren’s claim that such literature “constitutes a representational and rhetorical strategy.” Drawing on the work of political scientist Preston H. Smith II, it argues that African American literature represented an attempt to resolve the tensions between “racial democracy,” on the one hand, and social democracy on the other. The essay suggests that Sam Greenlee’s 1969 spy novel The Spook Who Sat By the Door anticipated some of Warren’s concerns and now allows us to see clearly how the demise of Jim Crow rendered any future rapprochement between racial and social democracy narratively untenable. In this way, Greenlee’s novel invites us to consider whether too much of a focus on how African American literature ends tends to distract us from the perhaps more important task of analyzing how it fails as an aesthetic practice in a post-Jim Crow world.Refracting Warren’s counterintuitive claim through the lens of Smith’s dialectic . . . makes clear that the demise of Jim Crow constitutes an aesthetic problem whereby African American literature enters a vexed, less clearly collaborative relationship with leftist politics.
Exceptionalism and Difference in American (Literary) Studies
Authors: Lawrence Jeffrey
Published: February 2023

This essay evaluates contemporary approaches to the study of American Exceptionalism through a review of two recent books: Ian Tyrrell’s American Exceptionalism: A New History of an Old Idea (2021) and Jordan Carson’s American Exceptionalism as Religion: Postmodern Discontent (2020). The essay argues that the two books provide compelling accounts of how discourses of American exceptionality have come to organize political, intellectual, and literary life in the US. However, it suggests that Tyrrell’s and Carson’s critiques of those discourses would benefit from a clearer heuristic distinction between the exceptionalist belief that the US is a singularly providential country and the empirically valid belief that it possesses a specific historical trajectory that differentiates it from other nation-states.After more than three decades of postexceptionalist scholarship that has trained us to look for circuits, symmetries, and solidarities across national lines, we would do well to return to . . . [asking] how particular US economic, political, and social differences have been created and maintained over time.
A Survey of the Literature
Authors: Lubin Joan
Published: February 2023

Datafication has a literary history. This essay takes up that history to repair to the apparent novelty of contemporary mass personalized politics the history of the novel as one cultural technology for personifying the masses. The machinery of mass personalization was set in motion long ago. However discrepant its emergent scenes may now seem, they have been multiply fused along the way, issuing from a common substrate of survey culture. Section 1 considers a magazine humor column linking the Elmira Community Study of voting and the Kinsey Reports on sex on the basis of their shared statistical methods. Section 2 considers the American Statistical Association’s proposition that statisticians are exemplars of democracy and its warning against the popular mistrust of their cultural prominence. Section 3 recasts the “death of the novel” as a name for the disruptive force of survey culture on literary value and the displacement of the classical genre system by the mass cultural genre system. Taking up mathematical formalism in the service of social realism, popular genres—science fiction, crime fiction, and erotica—and minority literatures ascendant in the mid-century US—gay, Black, and ethnic literatures—developed modes of narrative representation for an age of statistical aggregation.
Daggers at the Throat of Democracy: Democratic Erosion in the US and Abroad
Authors: Trabold Bryan
Published: February 2023

Nineteenth-Century American Activist Rhetorics (2021), edited by Patricia Bizzell and Lisa Zimmerelli, and Rhetorics of Democracy in the Americas (2021), edited by Adriana Angel, Michael L. Butterworth, and Nancy R. Gómez, both examine the complex relationship between rhetoric and democracy. In terms of their immediate scholarly objectives, these volumes clearly succeed. Nineteenth-Century American Activist Rhetorics, a 24-essay collection that employs a broad range of rhetorical approaches both classical and contemporary, provides a more comprehensive overview of rhetorical activism during that period in US history than any book published to date. Rhetorics of Democracy in the Americas, with its 11 essays written by scholars from Argentina, Brazil, Colombia, Mexico, and the US, who write not only about conditions in those countries but also in Cuba, Guatemala, and Venezuela, contains a range of perspectives in one volume that, to my knowledge, does not exist anywhere else. Taken together, both collections also provide compelling insights into the democratic erosion currently taking place around the world by illustrating how the intersection of violence, white supremacy, and religion pose an existential threat to democracy, particularly in the US.Taken together, both collections analyze rhetoric in vastly different times and places to identify and illuminate how the intersection of violence, white supremacy, and religion pose an existential threat to democracy, particularly in the US.
Novel Theory Beyond Democracy
Authors: Bronstein Michaela
Published: February 2023

Why has scholarship persistently treated novels about politics as irrelevant to the politics of fiction? This essay examines moments when scholarship sidelines novelistic representation of political activism and action, and suggests that novels of politics trouble a persistent gesture in scholarship by which novels and their characters are treated as representative—individuals standing in for classes, novels standing in for societies. But novels of politics often foreground tactical questions that fail to be representative; they look at political strategies that can’t or shouldn’t stand in the societies they hope to create, or at the way taking political action estranges individuals from the communities they hope to act for. Novels of politics look at what happens when individuals set out to trouble realism’s sense of “the way things happen” (James), and, in doing so, they raise broader questions about the gaps between means and the ends that are supposed to justify them.Scholarship of the novel . . . tends to see politics not as something that people . . . do, not a form of action, but as . . . a kind of mimesis: a problem of how social structures and populations . . . are made visible.
On the Uses and Abuses of Fascism
Authors: Bernstein Sanders Isaac
Published: February 2023

This essay reviews Bruce Kuklick’s Fascism Comes to America: A Century of Obsession in Politics and Culture (2022). It discusses how the book contributes to ongoing debates about defining fascism by offering a wide-ranging historical survey of the term’s use in the US and by, ultimately, questioning the term’s analytic value. Fascism Comes to America tracks the concept in the US over the past century, drawing on journalism, mass entertainment, and academic scholarship to illuminate its many contradictory applications. Considering both evolving uses of fascism leading up to World War II and its enduring legacy since, Kuklick’s historical survey posits that fascism has become little more than one of the “political swear words,” a sign of contempt without consistent descriptive content. It suggests scholars should consider jettisoning the term. While valuable for its rigorous scholarship, Fascism Comes to America does, though, overlook how fascism’s polysemy might resolve to more specific and consistent uses within distinct traditions within America. Rather than succeeding as an argument for why scholars should abandon the concept of fascism in a US context, Fascism Comes to America succeeds in illuminating how important it is to historicize one’s use of it.[T]o name something “fascist” is both a matter of analytic value and politics. For Bruce Kuklick, . . . the analytic value of the term fascism should be called into question.
Liberalism and Critique
Authors: Jelly-Schapiro Eli
Published: February 2023

The three books under discussion here evince the dialectic of liberalism and critique, and the imperative of joining critique and self-critique. Rachel Greenwald Smith’s On Compromise: Art, Politics, and the Fate of an American Ideal (2021) is a trenchant meditation on the cultural logics of liberalism in the moment of its putative triumph and global generalization. Patricia Stuelke’s The Ruse of Repair: US Neoliberal Empire and the Turn from Critique (2021) clarifies the origins and political consequence of reparative thinking and feeling—a cultural and intellectual tendency that has, Stuelke submits, permitted or encouraged artists, activists, and scholars to reconcile themselves to recent iterations of “US neoliberal empire” and the longer histories of racial capitalism and settler-colonial dispossession. The affinity that Stuelke reveals, between the language of imperial power and the language of its imagined transcendence, is anatomized by Erica Edwards, in The Other Side of Terror: Black Women and the Culture of US Empire (2021)—a cogent examination of the reciprocal relationship between the making of race and the making of war, and the complex positionality of Black women within the contemporary US imperium.The co-belonging of liberalism and critique often appears, to the critic or cultural producer, like complicity. There is an unsettling affinity . . . between the language we use to critique capital and the state, and the ideological lexicon of the forces that rule us.
“Why Talk About the Children?”: James Baldwin, Octavia Butler, and the Future of Care
Authors: Ibrahim Habiba
Published: February 2023

This essay argues that the child—especially the unborn child that is all potential—has a notably figurative function in the Black literary imagination of the 1970s. The child shifts the emphasis from an ideal nationalist subject (or the aspiration to be such) toward the interactions and ethics of care work. This shift is explored in the novel form, so this essay turns to James Baldwin’s If Beale Street Could Talk (1974) and Octavia Butler’s Kindred (1979). As these novels reveal, in a reactionary era when the emergence of neoliberal governance intensified the vulnerability of Black life, the child occasioned literary exploration of care—waged, unpaid, invisible, delegitimated, cross-gendered labor that has sustained Black lives for generations. On such an occasion, the child has a Janus-faced function. From the standpoint of an uncaring present, the child prompts a glance into the life-sustaining practices of the past, while it invites speculation over what future practices could be.As the conduit among imagined states of time, the child exhibits an unspoken interest in reimagining temporal movement—beyond nationalism’s progressive linearity—in an era of disillusionment.
Digital Storytelling: Changing Learners’ Attitudes and Self-efficacy Beliefs
Authors: Tecedor Marta
Published: February 2023

This study examines the impact of writing instruction on Spanish heritage language (SHL) learners’ attitudes towards digital stories (DS) and self-efficacy beliefs with regard to academic writing, multiliteracies, and computer abilities. Two types of writing instruction—a traditional curriculum centered around genres and a multiliteracies curriculum consisting of the interpretation and design of DSs—were implemented in fourth and fifth-semester SHL courses at a US university in the Southwest. Drawing on Gardner’s (1985) conceptualization of attitude, and Bandura’s (1991) construct of perceived self-efficacy, a survey was designed to explore changes in participants’ (n = 225) scores before and after the treatments. Confirmatory factor analysis was conducted to determine the reliability of the instrument and a latent mean structure analysis was used to explore differences among groups before and after the 16-week intervention period. Findings indicate that curricular changes aimed at developing multiliteracies benefitted participants in two of the four domains under examination: attitude towards DSs and self-efficacy in multiliteracies abilities. Areas in which participants exposed to the multiliteracies curriculum did not experience a positive impact—self-efficacy in academic writing abilities and computer abilities—provide insights into how multiliteracies abilities develop and potential modifications that can be implemented in the curriculum to maximize its positive impact.
The Best Under Stress: An Analysis of Breast Tissue Expander Response to External Forces
Authors: Najafali Daniel , Liu Farrah C , Raman Karanvir , Maheta Bhagvat , Saldana Golddy Milagros , Heldman Lucas , Cevallos Priscila , Nazerali Rahim
Published: February 2023

Background

The use of breast tissue expanders (TEs) in breast reconstruction is accompanied by undesired changes to the chest wall and lateral plane. Breast TEs are designed to create a naturally formed breast pocket by capitalizing on the ductile response of skin tissue; however, in practice, the use of expanders is accompanied by undesired changes to the chest wall and lateral plane.

Objectives

The authors of this study compared 3 comparably sized and commercially available breast TEs to assess the mechanical profile and functionality of each design.

Methods

Authors compared MENTOR Artoura PLUS Smooth (Irvine, CA), Allergan 133 Smooth (Irvine, CA), and Sientra AlloX2 Smooth (Santa Barbara, CA) filled to 100% of their label volume. The mechanical profile of TEs was assessed via vertical compression. Dimensions were recorded at baseline and percent changes were calculated at each compressive load (5-35 lbf intervals of 5 lbf).

Results

Base width and projection were recorded at compressive loads of 10, 20, and 35 lbs. For percent changes of base width, MENTOR had 0.98%, 2.09%, 3.84%; Allergan 4.21%, 9.15%, 15.52%; and Sientra 4.72%, 10.19%, 19.15%. For percent changes of projection, MENTOR had −19.06%, −25.44%, −30.88%, Allergan −35.53%, −42.90%, −50.09%, and Sientra −29.64%, −37.68%, −44.69%. For percent change of height, MENTOR had 1.44%, 2.62%, 4.27%, Allergan 10.26%, 16.49%, 22.97%, and Sientra 6.99%, 11.93%, 16.90%. MENTOR's TE had the most pronounced lower pole with volume expansion.

Conclusions

The MENTOR TE demonstrated the least lateral deformation and projection loss across the range of compressive loads, as well as the highest force resistance compared with the other models.

Level of Evidence: 3
Epileptogenesis in tuberous sclerosis complex-related developmental and epileptic encephalopathy
Authors: Aronica Eleonora , Specchio Nicola , Luinenburg Mark J , Curatolo Paolo
Published: February 2023

Epileptogenesis in infants with tuberous sclerosis complex (TSC) is a gradual and dynamic process, leading to early onset and difficult-to-treat seizures. Several cellular, molecular and pathophysiologic mechanisms, including mammalian target of rapamycin (mTOR) dysregulation, GABAergic dysfunction and abnormal connectivity, may play a role in this epileptogenic process and may also contribute to the associated developmental encephalopathy. Disease-specific antiseizure medications or drugs targeting the mTOR pathway have proved to be effective in TSC-associated epilepsy. Pre-symptomatic administration of vigabatrin, a GABAergic drug, delays seizure onset and reduces the risk of a subsequent epileptic encephalopathy, such as infantile spasms syndrome or Lennox–Gastaut syndrome. Everolimus, a rapamycin-derived mTOR inhibitor, reduces seizure frequency, especially in younger patients. This evidence suggests that everolimus should be considered early in the course of epilepsy.

Future trials are needed to optimize the use of everolimus and determine whether earlier correction of mTOR dysregulation can prevent progression to developmental and epileptic encephalopathies or mitigate their severity in infants with TSC. Clinical trials of several other potential antiseizure drugs (cannabidiol and ganaxolone) that target contributing mechanisms are also underway.

This review provides an overview of the different biological mechanisms occurring in parallel and interacting throughout the life course, even beyond the epileptogenic process, in individuals with TSC. These complexities highlight the challenges faced in preventing and treating TSC-related developmental and epileptic encephalopathy.
Erythematous tender nodules on the legs with oily exudate
Authors: Wright William A , Kamp Erin , Musbahi Esra , Koenig Michael , Quante Mara , Topham Emma
Published: February 2023

This 70-year-old woman presented with multiple tender erythematous nodules on her legs with some breaking down and discharging an oily substance. Histology showed extensive active chronic inflammation of the dermis and lobular panniculitis.
Reliability and validity of a measure to assess the health-related quality of life of women with alopecia areata
Authors: Rees Huw , Wall Dmitri , Bokhari Laita , Asfour Leila , Sinclair Rodney
Published: February 2023

Alopecia areata (AA) has an impact on health-related quality of life (HRQoL). The Women’s Androgenetic Alopecia Quality of Life (WAA-QoL) questionnaire is a reliable, validated HRQoL measure in women with androgenetic alopecia (AGA). There is no equivalent measure for female patients with AA. Data were collected as part of the Global Registry of Alopecia Areata Disease Severity and Treatment Safety (GRASS) Australia. The WAA-QoL, Dermatology Life Quality Index (DLQI) and Skindex-16 for AA, as well as the Severity of Alopecia Tool score, were extracted from GRASS for adult female patients. Cronbach’s alpha and factor analysis were employed to determine the internal consistency of the measure, and nonparametric correlation testing assessed the validity of the questionnaire. Overall, 137 individuals completed the questionnaires. There was excellent internal consistency of the WAA-QoL among women with AA (Cronbach’s α = 0.98). A moderate and high positive correlation was found between the WAA-QoL and the DLQI and the Skindex-16 for AA, respectively. The WAA-QoL is a reliable and valid assessment of HRQoL among women with AA.
Are sunscreens as transparent as they seem, or have they a murky factor?
Authors: Long Amy , Long Alison T , Murphy Lisa C
Published: February 2023

Recently, the safety profile of sunscreen has been questioned, as well as the impact of sunscreen on the environment. We examined SPF50 + sunscreen products from 10 popular skincare brands in the UK, to analyse the proportion of them containing ultraviolet (UV) filters implicated in environmental harm. We found that 52% of sunscreen products contained potentially harmful organic UV filters.
Concordance Between Initial Presumptive and Final Adjudicated Diagnoses of Infection Among Patients Meeting Sepsis-3 Criteria in the Emergency Department
Authors: Hooper Gabriel A , Klippel Carolyn J , McLean Sierra R , Stenehjem Edward A , Webb Brandon J , Murnin Emily R , Hough Catherine L , Bledsoe Joseph R , Brown Samuel M , Peltan Ithan D
Published: February 2023

Background

Guidelines emphasize rapid antibiotic treatment for sepsis, but infection presence is often uncertain at initial presentation. We investigated the incidence and drivers of false-positive presumptive infection diagnosis among emergency department (ED) patients meeting Sepsis-3 criteria.

Methods

For a retrospective cohort of patients hospitalized after meeting Sepsis-3 criteria (acute organ failure and suspected infection including blood cultures drawn and intravenous antimicrobials administered) in 1 of 4 EDs from 2013 to 2017, trained reviewers first identified the ED-diagnosed source of infection and adjudicated the presence and source of infection on final assessment. Reviewers subsequently adjudicated final infection probability for a randomly selected 10% subset of subjects. Risk factors for false-positive infection diagnosis and its association with 30-day mortality were evaluated using multivariable regression.

Results

Of 8267 patients meeting Sepsis-3 criteria in the ED, 699 (8.5%) did not have an infection on final adjudication and 1488 (18.0%) patients with confirmed infections had a different source of infection diagnosed in the ED versus final adjudication (ie, initial/final source diagnosis discordance). Among the subset of patients whose final infection probability was adjudicated (n = 812), 79 (9.7%) had only “possible” infection and 77 (9.5%) were not infected. Factors associated with false-positive infection diagnosis included hypothermia, altered mental status, comorbidity burden, and an “unknown infection source” diagnosis in the ED (odds ratio: 6.39; 95% confidence interval: 5.14–7.94). False-positive infection diagnosis was not associated with 30-day mortality.

Conclusions

In this large multihospital study, <20% of ED patients meeting Sepsis-3 criteria had no infection or only possible infection on retrospective adjudication.
Internationally Driven, but Domestically Aware, Legislation in Troubled Times: The First Copyright Statute in China
Authors: Lee Jyh-An , Li Yangzi
Published: February 2023

We use the 1910 Copyright Code of the Great Qing Dynasty (Qing Copyright Code) as a lens to understand China’s initial encounter with international intellectual property norms, examine the dynamic political economy in which the law was enacted, and provide an overview of the structure and important provisions of the Qing Copyright Code. We argue that, although foreign pressure was an important factor shaping the Qing Copyright Code, the Code was designed not to protect the economic interests of foreigners in China but to achieve a pair of distinct goals: advance China’s national interests in accessing Western knowledge and incentivize the production and dissemination of knowledge in the country. This argument is substantiated by not only the political economy of the legislation but also the later implementation of the law.
Concomitant aortic root replacement during frozen elephant trunk implantation does not increase perioperative risk
Authors: Berger Tim , Chikvatia Salome , Siepe Matthias , Kondov Stoyan , Meissl Dominic , Gottardi Roman , Rylski Bartosz , Czerny Martin , Kreibich Maximilian
Published: February 2023

OBJECTIVES

Our aim was to evaluate the risk of concomitant aortic root replacement during frozen elephant trunk (FET) total arch replacement.

METHODS

Between March 2013 and February 2021, 303 patients underwent aortic arch replacement using the FET technique. Patient characteristics, intra- and postoperative data were compared between patients with (n = 50) and without (n = 253) concomitant aortic root replacement (implantation of a valved conduit or using the reimplantation valve-sparing technique) after propensity score matching.

RESULTS

After propensity score matching, there were no statistically significant differences in preoperative characteristics including the underlying pathology. There was no statistically significant difference regarding arterial inflow-cannulation or concomitant cardiac procedures, while cardiopulmonary bypass (P < 0.001) and aortic cross-clamp (P < 0.001) times were significantly longer in the root replacement group. Postoperative outcome was similar between the groups and there were no proximal reoperations in the root replacement group during follow-up. Root replacement was not predictive for mortality (P = 0.133, odds ratio: 0.291) in our Cox regression model. There was no statistically significant difference in overall survival (log rank: P = 0.062).

CONCLUSIONS

Concomitant FET implantation and aortic root replacement prolongs operative times but does not influence postoperative outcomes or increase operative risk in an experienced high-volume centre. The FET procedure did not appear to be a contraindication for concomitant aortic root replacement even in patients with borderline indications for aortic root replacement.
Outcomes of type A acute aortic dissection with cardiopulmonary arrest: Tokyo Acute Aortic Super-network Registry
Authors: Yamasaki Manabu , Yoshino Hideaki , Kunihara Takashi , Akutsu Koichi , Shimokawa Tomoki , Ogino Hitoshi , Kawata Mitsuhiro , Takahashi Toshiyuki , Usui Michio , Watanabe Kazuhiro , Fujii Takeshiro , Yamamoto Takeshi , Nagao Ken , Takayama Morimasa
Published: February 2023

OBJECTIVES

Preventing loss of life in patients with type A acute aortic dissection (AAD) who present with cardiopulmonary arrest (CPA) can be extremely difficult. Thus, we investigated the early outcomes in these patients.

METHODS

Patients with type A AAD who were transported to hospitals belonging to the Tokyo Acute Aortic Super-network between January 2015 and December 2019 were considered for this study. We assessed the early mortality of these patients presenting with CPA and also investigated the differences in outcomes between patients with out-of-hospital and in-hospital CPA.

RESULTS

A total of 3307 patients with type A AAD were transported, 434 (13.1%) of whom presented with CPA. The overall mortality of patients presenting with CPA was 88.2% (383/434), of which 94.5% (240/254) experienced out-of-hospital CPA and 79.4% (143/180) experienced in-hospital CPA (P < 0.001). Multivariable analysis revealed that aortic surgery [odds ratio (OR), 0.022; 95% confidence interval (CI), 0.008–0.060; P < 0.001] and patient age over 80 years (OR, 2.946; 95% CI, 1.012–8.572; P = 0.047) were related with mortality in patients with type A AAD and CPA. Between in-hospital and out-of-hospital CPA, the proportions of DeBakey type 1 (OR, 2.32; 95% CI, 1.065–5.054; P = 0.034), cerebral malperfusion (OR, 0.188; 95% CI, 0.056–0.629; P = 0.007), aortic surgery (OR, 0.111; 95% CI, 0.045–0.271; P = 0.001), age (OR, 0.969; 95% CI, 0.940–0.998; P = 0.039) and the time from symptom onset to hospital admission (OR, 1.122; 95% CI, 1.025–1.228; P = 0.012) were significantly different.

CONCLUSIONS

Patients with type A AAD presenting with CPA exhibited extremely high rates of death. Patient outcomes following in-hospital CPA tended to be better than those following out-of-hospital CPA; however, this difference was not significantly different. To prevent deaths, aortic surgery, when possible, should be considered in patients with type A AAD who sustained CPA.
Young adults’ labour market transitions and intergenerational support in Germany
Authors: Manzoni Anna , Gebel Michael
Published: February 2023

Research has shown that parents provide considerable support to their children; however, we know little about the influence of young adults’ employment experiences on the support they receive from their parents. We draw on data from the German Family Panel pairfam for birth cohorts 1981–1983 and 1991–1993 and use a first difference panel estimator with asymmetric effects to examine the extent to which young adults’ employment transitions affect material, emotional, and instrumental support from parents. We find stark differences across types of support: parental material support changes in response to transitions in and out of employment, especially when to and from education. Other types of support seem less contingent on labour market transitions. Instrumental support only increases for transitions from education to employment and from employment to NEET. The latter effect is mainly driven by women entering parental leave. We do not find strong evidence of differences between transitions to standard and non-standard work. The association between employment transitions and intergenerational material support flows suggests that families act as safety nets, raising concerns about those whose families are unable to help.
Intensity-specific considerations for exercise for patients with inflammatory bowel disease
Authors: Ordille Andrew J , Phadtare Sangita
Published: February 2023

The rising prevalence of inflammatory bowel disease (IBD) necessitates that patients be given increased access to cost-effective interventions to manage the disease. Exercise is a non-pharmacologic intervention that advantageously affects clinical aspects of IBD, including disease activity, immune competency, inflammation, quality of life, fatigue, and psychological factors. It is well established that exercise performed at low-to-moderate intensity across different modalities manifests many of these diseased-related benefits while also ensuring patient safety. Much less is known about higher-intensity exercise. The aim of this review is to summarize findings on the relationship between strenuous exercise and IBD-related outcomes. In healthy adults, prolonged strenuous exercise may unfavorably alter a variety of gastrointestinal (GI) parameters including permeability, blood flow, motility, and neuro-endocrine changes. These intensity- and gut-specific changes are hypothesized to worsen IBD-related clinical presentations such as diarrhea, GI bleeding, and colonic inflammation. Despite this, there also exists the evidence that higher-intensity exercise may positively influence microbiome as well as alter the inflammatory and immunomodulatory changes seen with IBD. Our findings recognize that safety for IBD patients doing prolonged strenuous exercise is no more compromised than those doing lower-intensity work. Safety with prolonged, strenuous exercise may be achieved with adjustments including adequate hydration, nutrition, drug avoidance, and careful attention to patient history and symptomatology. Future work is needed to better understand this intensity-dependent relationship so that guidelines can be created for IBD patients wishing to participate in high-intensity exercise or sport.
Egg Yolk Protein Homologs Identified in Live-Bearing Sharks: Co-Opted in the Lecithotrophy-to-Matrotrophy Shift?
Authors: Ohishi Yuta , Arimura Shogo , Shimoyama Koya , Yamada Kazuyuki , Yamauchi Shinya , Horie Taku , Hyodo Susumu , Kuraku Shigehiro
Published: February 2023

Reproductive modes of vertebrates are classified into two major embryonic nutritional types: yolk deposits (i.e., lecithotrophy) and maternal investment (i.e., matrotrophy). Vitellogenin (VTG), a major egg yolk protein synthesized in the female liver, is one of the molecules relevant to the lecithotrophy-to-matrotrophy shift in bony vertebrates. In mammals, all VTG genes are lost following the lecithotrophy-to-matrotrophy shift, and it remains to be elucidated whether the lecithotrophy-to-matrotrophy shift in nonmammalians is also associated with VTG repertoire modification. In this study, we focused on chondrichthyans (cartilaginous fishes)—a vertebrate clade that underwent multiple lecithotrophy-to-matrotrophy shifts. For an exhaustive search of homologs, we performed tissue-by-tissue transcriptome sequencing for two viviparous chondrichthyans, the frilled shark Chlamydoselachus anguineus and the spotless smooth-hound Mustelus griseus, and inferred the molecular phylogeny of VTG and its receptor very low-density lipoprotein receptor (VLDLR), across diverse vertebrates. As a result, we identified either three or four VTG orthologs in chondrichthyans including viviparous species. We also showed that chondrichthyans had two additional VLDLR orthologs previously unrecognized in their unique lineage (designated as VLDLRc2 and VLDLRc3). Notably, VTG gene expression patterns differed in the species studied depending on their reproductive mode; VTGs are broadly expressed in multiple tissues, including the uterus, in the two viviparous sharks, and in addition to the liver. This finding suggests that the chondrichthyans VTGs do not only function as the yolk nutrient but also as the matrotrophic factor. Altogether, our study indicates that the lecithotrophy-to-matrotrophy shift in chondrichthyans was achieved through a distinct evolutionary process from mammals.
An Interpretation of Articles 18-23 of Directive (EU) 2019/790: Open Issues in Contractual Copyright and Related Rights Law
Authors: Bossi Ludovico
Published: February 2023

Although creators have always been placed at the centre of the copyright system, they generally face difficulties in being fairly remunerated for their work. Articles 18-23 Directive (EU) 2019/790 require Member States to establish a series of protective measures in favour of authors and performers who license or transfer the exclusive economic rights to their works or performances to third parties for the purpose of exploitation. These measures constitute an absolute novelty at the European Union level and at the level of most Member States, and present a potential which must not be wasted. However, these provisions are in many ways complex and ambiguous, so that their effectiveness could be undermined in various ways. This article focuses on some still open issues concerning Arts. 18-23 Directive (EU) 2019/790 and attempts to provide the most appropriate interpretation in order to achieve the intended goals. In doing so, particular attention is paid to previous fragmented national and European experiences in the field of contractual copyright and related rights law.
Exploring balanced harvest as a potential strategy for highly exploited multispecies fisheries
Authors: Sun Runlong , Sun Peng , Fu Caihong , Liu Guankui , Liang Zhenlin , Shin Yunne-Jai , Barrier Nicolas , Tian Yongjun
Published: February 2023

Balanced harvest (BH) proposes moderate fishing mortality rates across all species or sizes in proportion to productivity, serving as a possible strategy for ecosystem-based fisheries management. Fishing patterns in some developing countries (e.g. China, the largest producer of seafood) closely resemble BH, where catches have been highly diversified by unselective gears due to market demand for almost all species. In this study, we employed an OSMOSE ecosystem model developed for the Yellow Sea in China to investigate the potential occurrences and advantages of BH in this region with highly exploited multispecies fisheries. Simulations were carried out under four types of fishing scenarios, where various levels of fishing mortality rates for all species or specific functional groups were implemented. Results indicated that the occurrences of BH depended on fishing pressure and targeted functional groups, and that size-level BH was significantly correlated with biomass and yield for most species. In particular, varying fishing pressure for certain functional groups resulted in BH, which produced a high yield for specific species and ensured their biomass sustainability. We concluded that the benefits of BH could be potentially achieved by adjusting fishing pressure for certain functional groups based on the existing fishing pattern in over-exploited ecosystems.
Dead Users’ Profiles on Facebook: Limited Interaction Beyond Human Existence
Authors: Trevisan Daniele , Maciel Cristiano , Pereira Vinícius Carvalho , Pereira Roberto
Published: February 2023

Death has become increasingly visible on social networks, especially after COVID-19, and Facebook addresses that with double standards: while some profiles remain active, others turn into memorials. This article investigates how Facebook’s system deals with dead users’ profiles either to support or restrict interactions concerning users’ deaths. Our qualitative analysis of data from 54 public profiles of people who died between June 2020 and March 2021 showed that (i) Facebook fails to communicate the criteria for transforming profiles into memorials; (ii) no information about their contacts of deceased users’ profiles is given; (iii) the frequency of interaction with memorials and with active profiles is different; (iv) profiles’ privacy settings shape interaction. Our results exemplify how a sociotechnical system influences people’s interactions with dead users’ profiles. We herein highlight implications for interaction design and evaluation, besides the need to consider interaction as existence, which raises big challenges to the Human Computer Interaction (HCI) community.
The Perception of the Utility of Social Media by Caregivers of Persons with Autism Spectrum Disorders during a Period of Home Quarantine
Authors: Guidi Stefano , Palmitesta Paola , Bracci Margherita , Marchigiani Enrica , Parlangeli Oronzo
Published: February 2023

During the COVID-19 pandemic, the use of social media offered a possible way to address the difficulties of social relationships for people with autism spectrum disorder (ASD), as well as a way to ease the problems of their caregivers. To gather information on the feasibility of this solution, we conducted an online questionnaire about the first lockdown period in Italy (March–May 2020) with 29 caregivers of ASD individuals. The questionnaire investigated their living conditions, the way time was spent during isolation, the availability of technological equipment, the perceived level of anxiety and the perceived utility of social media. The results showed that the difficulties of using social media had not been overcome, even at this time of greatest need. However, caregivers who take care of ASD people with high levels of anxiety perceived social media as more useful. This result invites further reflection on how to implement social media effectively for people with ASD.
A multi-site randomized trial of a clinical decision support intervention to improve problem list completeness
Authors: Wright Adam , Schreiber Richard , Bates David W , Aaron Skye , Ai Angela , Cholan Raja Arul , Desai Akshay , Divo Miguel , Dorr David A , Hickman Thu-Trang , Hussain Salman , Just Shari , Koh Brian , Lipsitz Stuart , Mcevoy Dustin , Rosenbloom Trent , Russo Elise , Ting David Yut-Chee , Weitkamp Asli , Sittig Dean F
Published: February 2023

Objective

To improve problem list documentation and care quality.

Materials and methods

We developed algorithms to infer clinical problems a patient has that are not recorded on the coded problem list using structured data in the electronic health record (EHR) for 12 clinically significant heart, lung, and blood diseases. We also developed a clinical decision support (CDS) intervention which suggests adding missing problems to the problem list. We evaluated the intervention at 4 diverse healthcare systems using 3 different EHRs in a randomized trial using 3 predetermined outcome measures: alert acceptance, problem addition, and National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set (NCQA HEDIS) clinical quality measures.

Results

There were 288 832 opportunities to add a problem in the intervention arm and the problem was added 63 777 times (acceptance rate 22.1%). The intervention arm had 4.6 times as many problems added as the control arm. There were no significant differences in any of the clinical quality measures.

Discussion

The CDS intervention was highly effective at improving problem list completeness. However, the improvement in problem list utilization was not associated with improvement in the quality measures. The lack of effect on quality measures suggests that problem list documentation is not directly associated with improvements in quality measured by National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set (NCQA HEDIS) quality measures. However, improved problem list accuracy has other benefits, including clinical care, patient comprehension of health conditions, accurate CDS and population health, and for research.

Conclusion

An EHR-embedded CDS intervention was effective at improving problem list completeness but was not associated with improvement in quality measures.
Contrast-enhanced Mammography-guided Biopsy: Initial Trial and Experience
Authors: Kowalski Aneta , Arefan Dooman , Ganott Marie A , Harnist Kimberly , Kelly Amy E , Lu Amy , Nair Bronwyn E , Sumkin Jules H , Vargo Adrienne , Berg Wendie A , Zuley Margarita L
Published: February 2023

Objective

Evaluate lesion visibility and radiologist confidence during contrast-enhanced mammography (CEM)-guided biopsy.

Methods

Women with BI-RADS ≥4A enhancing breast lesions were prospectively recruited for 9-g vacuum-assisted CEM-guided biopsy. Breast density, background parenchymal enhancement (BPE), lesion characteristics (enhancement and conspicuity), radiologist confidence (scale 1–5), and acquisition times were collected. Signal intensities in specimens were analyzed. Patient surveys were collected.

Results

A cohort of 28 women aged 40–81 years (average 57) had 28 enhancing lesions (7/28, 25% malignant). Breast tissue was scattered (10/28, 36%) or heterogeneously dense (18/28, 64%) with minimal (12/28, 43%), mild (7/28, 25%), or moderate (9/28, 32%) BPE on CEM. Twelve non-mass enhancements, 11 masses, 3 architectural distortions, and 2 calcification groups demonstrated weak (12/28, 43%), moderate (14/28, 50%), or strong (2/28, 7%) enhancement. Specimen radiography demonstrated lesion enhancement in 27/28 (96%). Radiologists reported complete lesion removal on specimen radiography in 8/28 (29%). Average time from contrast injection to specimen radiography was 18 minutes (SD = 5) and, to post-procedure mammogram (PPM), 34 minutes (SD = 10). Contrast-enhanced mammography PPM was performed in 27/28 cases; 13/19 (68%) of incompletely removed lesions on specimen radiography showed residual enhancement; 6/19 (32%) did not. Across all time points, average confidence was 2.2 (SD = 1.2). Signal intensities of enhancing lesions were similar to iodine. Patients had an overall positive assessment.

Conclusion

Lesion enhancement persisted through PPM and was visible on low energy specimen radiography, with an average “confident” score. Contrast-enhanced mammography-guided breast biopsy is easily implemented clinically. Its availability will encourage adoption of CEM.
Not welcome anymore: the effect of electoral incentives on the reception of refugees
Authors: Gamalerio Matteo , Negri Margherita
Published: February 2023

Do electoral incentives affect immigration policies? Exploiting the Italian system for refugees’ reception and data from Italian municipalities, we show that proximity to elections reduces the probability that a municipality applies to host a refugee center by 26%, despite the economic benefits arising from these centers. Low electoral competition and high shares of extreme-right voters drive the effect. Our results are rationalized by a theoretical model and can explain the unequal distribution of refugees across and within countries.