bluuebunny/crossref_metadata_2025 huggingface dataset:
Target attainment and population pharmacokinetics of flucloxacillin in critically ill patients: a multicenter study
Authors: Meenks Sjoerd D. , Punt Nieko , le Noble Jos L. M. L. , Foudraine Norbert A. , Neef Kees , Janssen Paddy K. C.
Published: March 2023

Purpose

Insufficient antimicrobial exposure has been associated with worse clinical outcomes. Reportedly, flucloxacillin target attainment in critically ill patients was heterogeneous considering the study population selection and reported target attainment percentages. Therefore, we assessed flucloxacillin population pharmacokinetics (PK) and target attainment in critically ill patients.

Methods

This prospective, multicenter, observational study was conducted from May 2017 to October 2019 and included adult, critically ill patients administered flucloxacillin intravenously. Patients with renal replacement therapy or liver cirrhosis were excluded. We developed and qualified an integrated PK model for total and unbound serum flucloxacillin concentrations. Monte Carlo dosing simulations were performed to assess target attainment. The unbound target serum concentration was four times the minimum inhibitory concentration (MIC) for ≥ 50% of the dosing interval (ƒT>4xMIC ≥ 50%).

Results

We analyzed 163 blood samples from 31 patients. A one-compartment model with linear plasma protein binding was selected as most appropriate. Dosing simulations revealed 26% ƒT>2 mg/L ≥ 50% following continuous infusion of 12 g flucloxacillin and 51% ƒT>2 mg/L ≥ 50% for 24 g.

Conclusion

Based on our dosing simulations, standard flucloxacillin daily doses of up to 12 g may substantially enhance the risk of underdosing in critically ill patients. Prospective validation of these model predictions is needed.
Tumor microenvironment remodeling after neoadjuvant immunotherapy in non-small cell lung cancer revealed by single-cell RNA sequencing
Authors: Hu Junjie , Zhang Lele , Xia Haoran , Yan Yilv , Zhu Xinsheng , Sun Fenghuan , Sun Liangdong , Li Shuangyi , Li Dianke , Wang Jin , Han Ya , Zhang Jing , Bian Dongliang , Yu Huansha , Chen Yan , Fan Pengyu , Ma Qiang , Jiang Gening , Wang Chenfei , Zhang Peng
Published: March 2023

Background

Immunotherapy has revolutionized cancer treatment, but most patients are refractory to immunotherapy or acquire resistance, with the underlying mechanisms remaining to be explored.

Methods

We characterized the transcriptomes of ~92,000 single cells from 3 pre-treatment and 12 post-treatment patients with non-small cell lung cancer (NSCLC) who received neoadjuvant PD-1 blockade combined with chemotherapy. The 12 post-treatment samples were categorized into two groups based on pathologic response: major pathologic response (MPR; n = 4) and non-MPR (NMPR; n = 8).

Results

Distinct therapy-induced cancer cell transcriptomes were associated with clinical response. Cancer cells from MPR patients exhibited a signature of activated antigen presentation via major histocompatibility complex class II (MHC-II). Further, the transcriptional signatures of FCRL4+FCRL5+ memory B cells and CD16+CX3CR1+ monocytes were enriched in MPR patients and are predictors of immunotherapy response. Cancer cells from NMPR patients exhibited overexpression of estrogen metabolism enzymes and elevated serum estradiol. In all patients, therapy promoted expansion and activation of cytotoxic T cells and CD16+ NK cells, reduction of immunosuppressive Tregs, and activation of memory CD8+T cells into an effector phenotype. Tissue-resident macrophages were expanded after therapy, and tumor-associated macrophages (TAMs) were remodeled into a neutral instead of an anti-tumor phenotype. We revealed the heterogeneity of neutrophils during immunotherapy and identified an aged CCL3+ neutrophil subset was decreased in MPR patients. The aged CCL3+ neutrophils were predicted to interact with SPP1+ TAMs through a positive feedback loop to contribute to a poor therapy response.

Conclusions

Neoadjuvant PD-1 blockade combined with chemotherapy led to distinct NSCLC tumor microenvironment transcriptomes that correlated with therapy response. Although limited by a small patient sample size subjected to combination therapy, this study provides novel biomarkers to predict therapy response and suggests potential strategies to overcome immunotherapy resistance.
Epigenome-wide association study in Chinese monozygotic twins identifies DNA methylation loci associated with blood pressure
Authors: Wang Weijing , Yao Jie , Li Weilong , Wu Yili , Duan Haiping , Xu Chunsheng , Tian Xiaocao , Li Shuxia , Tan Qihua , Zhang Dongfeng
Published: March 2023

Background

Hypertension is a crucial risk factor for developing cardiovascular disease and reducing life expectancy. We aimed to detect DNA methylation (DNAm) variants potentially related to systolic blood pressure (SBP) and diastolic blood pressure (DBP) by conducting epigenome-wide association studies in 60 and 59 Chinese monozygotic twin pairs, respectively.

Methods

Genome-wide DNA methylation profiling in whole blood of twins was performed using Reduced Representation Bisulfite Sequencing, yielding 551,447 raw CpGs. Association between DNAm of single CpG and blood pressure was tested by applying generalized estimation equation. Differentially methylated regions (DMRs) were identified bycomb-Papproach. Inference about Causation through Examination of Familial Confounding was utilized to perform the causal inference. Ontology enrichment analysis was performed using Genomic Regions Enrichment of Annotations Tool. Candidate CpGs were quantified using Sequenom MassARRAY platform in a community population. Weighted gene co-expression network analysis (WGCNA) was conducted using gene expression data.

Results

The median age of twins was 52 years (95% range 40, 66). For SBP, 31 top CpGs (p < 1 × 10–4) and 8 DMRs were identified, with several DMRs withinNFATC1,CADM2,IRX1,COL5A1, andLRAT. For DBP, 43 top CpGs (p < 1 × 10–4) and 12 DMRs were identified, with several DMRs withinWNT3A,CNOT10, andDAB2IP. Important pathways, such as Notch signaling pathway, p53 pathway by glucose deprivation, and Wnt signaling pathway, were significantly enriched for SBP and DBP. Causal inference analysis suggested that DNAm at top CpGs withinNDE1,MYH11,SRRM1P2, andSMPD4influenced SBP, while SBP influenced DNAm at CpGs withinTNK2. DNAm at top CpGs withinWNT3Ainfluenced DBP, while DBP influenced DNAm at CpGs withinGNA14. Three CpGs mapped toWNT3Aand one CpG mapped toCOL5A1were validated in a community population, with a hypermethylated and hypomethylated direction in hypertension cases, respectively. Gene expression analysis by WGCNA further identified some common genes and enrichment terms.

Conclusion

We detect many DNAm variants that may be associated with blood pressure in whole blood, particularly the loci withinWNT3AandCOL5A1. Our findings provide new clues to the epigenetic modification underlying hypertension pathogenesis.
Impact of a strategy based on unique blood culture sampling on contamination rate and detection of bloodstream infections in critically ill patients
Authors: Mahieu Rafael , Lemarié Carole , Douillet Delphine , Mercat Alain , Cormier Hélène , Eveillard Matthieu , Dubée Vincent , Riou Jérémie , Kouatchet Achille
Published: March 2023

Background

Unique blood culture (UBC) has been proposed to limit the number of venipuncture and to decrease the risk of BC contaminations (BCC) without affecting their yield. We hypothesized that a multi-faceted program based on UBC in the ICU may reduce the rate of contaminants with a similar performance for bloodstream infections (BSI) identification.

Methods

In a before and after design, we compared the proportion of BSI and BCC. A first 3-year period with multi-sampling (MS) strategy followed by a 4-month washout period, where staff received education and training for using UBC, and a 32-month period, where UBC was routinely used, while education and feedback were maintained. During the UBC period, a large volume of blood (40 mL) was sampled through a unique venipuncture with additional BC collections discouraged for 48 h.

Results

Of the 4,491 patients included (35% female patients, mean age 62 years) 17,466 BC were collected. The mean volume of blood per bottle collected increased from 2.8 ± 1.8 mL to 8.2 ± 3.9 mL between the MS and UBC periods, P < 0.01. A 59.6% reduction (95% CI 56.7–62.3; P < 0.001) of BC bottles collected per week was observed between the MS and UBC periods. The rate of BCC per patient decreased between the two periods from 11.2% to 3.8% (73.4% reduction; P < 0.001) for the MS and UBC periods, P < 0.001. Meanwhile, the rate of BSI per patient remained stable at 13.2% and 13.2% for the MS and UBC periods, P = 0.98.

Conclusions

In ICU patients, a strategy based on UBC reduces the contamination rate of cultures without affecting their yield.

Graphical Abstract
A congestion control scheme based on path recovery for smart grid communication
Authors: Ji Yanpeng , Zeng Siming , Zhao Jianli , Liu Liangshuai , Feng Haiyan , Shen Xingdi , Liu Deliang
Published: March 2023

In order to solve the problem that the original path forwarding traffic caused by congestion that cannot be recovered in time in Smart Grid Communication, a congestion control scheme RFCC (Router Forwarding Congestion Control) based on path recovery is proposed, which not only supports the receiving end combined with router nodes to relieve congestion, it can also solve the problem of low transmission performance caused by not being able to restore the original path in time after the traffic is transferred. Active queue management technology is used to detect congestion and notify downflow nodes (users and routers) in time, which trigger downflow users to adjust the request sending window and intermediate routers to transfer packets. In addition, the original path traffic is restored in time through the path recovery policy. Firstly, the path traffic is recovered according to the congestion mark carried by the subsequent content packets. Secondly, the transmission frequency of the probe packets is calculated according to the information such as the packet queue length of routers and the available bandwidth of the congested path, and the probe packets are periodically sent to the congested path, and the traffic is sent to the congested path in time. The alternate path is transferred back to the original path. This paper implements the scheme in NS-3, and extensive experiments show that the proposed scheme outperforms the comparison schemes, which not only higher and more stable throughput can be obtained, but also shorter and more stable transmission delay can be obtained. In addition, the optimal path transmission volume and link utilization are improved.
Novel advances in high-order numerical algorithm for evaluation of the shallow water wave equations
Authors: Poochinapan Kanyuta , Wongsaijai Ben
Published: March 2023

In this paper, we propose a high-order nonlinear algorithm based on a finite difference method modification to the regularized long wave equation and the Benjamin–Bona–Mahony–Burgers equation subject to the homogeneous boundary. The consequence system of nonlinear equations typically trades with high computation burden. This dilemma can be overcome by establishing a fast numerical algorithm procedure without a reduction of numerical accuracy. The proposed algorithm forms a linear system with constant coefficient matrix at each time step and produces numerical solutions, which remarkably gains many computational advantages. In terms of analysis, a priori estimation for the numerical solution is derived to obtain the convergence and stability analysis. Additionally, the algorithm is globally mass preserving to avoid nonphysical behavior. Two benchmarks, including a single solitary wave to both equations, are given to validate the applicability and accuracy of the proposed method. Numerical results are obtained and compared to other approaches available in the literature. From the comparisons it is clear that the proposed approach produces accurate and precise results at low computational cost. Besides, the proposed scheme is applied to study the effect of the viscous term on a single solitary wave. It is shown that the viscous term results in the amplitude and width of the initial condition but not in its velocities in the case of a single solitary wave. As a consequence, theoretical and numerical findings provide a new area to investigate and expand the high-order algorithm for the family of wave equations.
Podcasts’ effects on the EFL classroom: a socially relevant intervention
Authors: Chaves-Yuste Beatriz , de-la Peña Cristina
Published: March 2023

ICT tools have gained particular importance in the English as a foreign language classroom in order to promote students’ interaction, exchange of opinions, negotiation of meaning, or digital competence. Technological development and the impact of multimedia and virtual spaces on students’ lives make educational institutions and teachers explore new tools and strategies to learn the target language. Podcasts present content available on the Internet and can become an influential teaching strategy that may improve the teaching–learning process of EFL. This study aims to investigate the effect of audio podcasts, which deal with social inequality issues, on secondary education students’ EFL linguistic competence. A sample of seventy-eight students was randomly distributed into a control and an experimental group during a term in a high school in Madrid (Spain). As instruments for data collection, the grades obtained in the different skills in the pre and post-tests and the different task performance scores were analysed in both groups. The methodological framework is defined as a quasi-experimental design that provides quantitative data. The results confirm the hypothesis that the creation and use of podcasts are beneficial for improving EFL linguistic competence, especially speaking and listening skills. Practical implications aimed at organising English classes to improve EFL proficiency are discussed.

Graphical Abstract
Statistical analysis for EUV dynamic spectra and their impact on the ionosphere during solar flares
Authors: Nishimoto Shohei , Watanabe Kyoko , Jin Hidekatsu , Kawai Toshiki , Imada Shinsuke , Kawate Tomoko , Otsuka Yuichi , Shinbori Atsuki , Tsugawa Takuya , Nishioka Michi
Published: March 2023

The X-rays and extreme ultraviolet (EUV) emitted during solar flares can rapidly change the physical composition of Earth’s ionosphere, causing space weather phenomena. It is important to develop an accurate understanding of solar flare emission spectra to understand how it affects the ionosphere. We reproduced the entire solar flare emission spectrum using an empirical model and physics-based model, and input it into the Earth’s atmospheric model, GAIA to calculate the total electron content (TEC) enhancement due to solar flare emission. We compared the statistics of nine solar flare events and calculated the TEC enhancements with the corresponding observed data. The model used in this study was able to estimate the TEC enhancement due to solar flare emission with a correlation coefficient greater than 0.9. The results of this study indicate that the TEC enhancement due to solar flare emission is determined by soft X-ray and EUV emission with wavelengths shorter than 35 nm. The TEC enhancement is found to be largely due to the change in the soft X-ray emission and EUV line emissions with wavelengths, such as Fe XVII 10.08 nm, Fe XIX 10.85 nm and He II 30.38 nm.

Graphical Abstract
Plasma bioactive adrenomedullin on intensive care unit admission is associated with acute respiratory distress syndrome: an observational study
Authors: Johnsson Patrik , Fredriksson Andrea , Tung Christer , Friberg Hans , Frigyesi Attila
Published: March 2023

Background

Bioactive adrenomedullin (bio-ADM) is a vasoactive peptide with a key role in reducing vascular hyperpermeability and improving endothelial stability during infection, but it also has vasodilatory properties. Bioactive ADM has not been studied in conjunction with acute respiratory distress syndrome (ARDS), but it has recently been shown to correlate with outcomes after severe COVID-19. Therefore, this study investigated the association between circulating bio-ADM on intensive care unit (ICU) admission and ARDS. The secondary aim was the association between bio-ADM and ARDS mortality.

Methods

We analysed bio-ADM levels and assessed the presence of ARDS in adult patients admitted to two general intensive care units in southern Sweden. Medical records were manually screened for the ARDS Berlin criteria. The association between bio-ADM levels and ARDS and mortality in ARDS patients was analysed using logistic regression and receiver-operating characteristics analysis. The primary outcome was an ARDS diagnosis within 72 h of ICU admission, and the secondary outcome was 30-day mortality.

Results

Out of 1224 admissions, 11% (n = 132) developed ARDS within 72 h. We found that elevated admission bio-ADM level was associated with ARDS independently of sepsis status and of organ dysfunction as measured by the Sequential organ failure assessment (SOFA) score. Both lower levels (< 38 pg/L) and high (> 90 pg/L) levels of bio-ADM were independently (of the Simplified acute physiology score, SAPS-3) predictive of mortality. Patients with indirect mechanisms of lung injury had higher bio-ADM levels than those with a direct mechanism of injury, and bio-ADM increased with increasing ARDS severity.

Conclusions

High levels of bio-ADM on admission are associated with ARDS, and bio-ADM levels significantly differ depending on the injury mechanism. In contrast, both high and low levels of bio-ADM are associated with mortality, possibly due to the dual action of bio-ADM in stabilising the endothelial barrier and causing vasodilation. These findings could lead to improved diagnostic accuracy of ARDS and potentially lead to new therapeutic strategies.
Successful resection of port site recurrence of pancreatic ductal adenocarcinoma after laparoscopic distal pancreatectomy
Authors: Aida Takashi , Iwase Ryota , Usuba Teruyuki , Kumagai Yu , Furukawa Kenei , Onda Shinji , Ogawa Masaichi , Ikegami Toru
Published: March 2023

Background

There are many reports of port site recurrence after laparoscopic surgery for various types of cancer. However, only two cases of port site recurrence after laparoscopic pancreatectomy have been reported to date. We herein report a case of port site recurrence after laparoscopic distal pancreatectomy.

Case presentation

A 73-year-old woman was diagnosed with pancreatic tail cancer and underwent laparoscopic distal pancreatectomy with splenectomy. Histopathological examination revealed pancreatic ductal carcinoma (pT1N0M0 pStage I). The patient was discharged on postoperative day 14 with no complications. However, 5 months after surgery, computed tomography showed a small tumor at the right abdominal wall. No distant metastasis had appeared after 7 months of follow-up. Under the diagnosis of port site recurrence without any other metastases, we resected this abdominal tumor. Histopathological examination showed port site recurrence of pancreatic ductal carcinoma. No recurrence was observed 15 months postoperatively.

Conclusions

This is the report of successful resection of port site recurrence of pancreatic cancer.
Degradation and restoration of Indigenous California black oak (Quercus kelloggii) stands in the northern Sierra Nevada
Authors: Stephens Scott L. , Hall Les , Stephens Connor W. , Bernal Alexis A. , Collins Brandon M.
Published: March 2023

Background

The cultural connections of the Maidu to the lands they inhabit are profound with burning being a major component of their culture. California black oak plays an important role in the lifeways of many Indigenous tribes and Native peoples tend black oaks. We used multiple lines of evidence to reconstruct Indigenous fire use in a mixed conifer forest in the northern Sierra Nevada. This includes summarizing oral traditions by the Mountain Maidu, quantifying current and historical forest structure, and characterizing fire effects in an area impacted by the 2021 Dixie Fire.

Results

The promotion of fire, both lighting- and human-ignited, has always been part of Mountain Maidu land stewardship. The mixed conifer forests in our focal study site had very high tree densities that were dominated by small, shade-tolerant species and the historic mean fire return interval was 8.6 years. Twenty-three fire intervals of 10 years or less and 11 fire intervals of 5 years or less were recorded. Based on forest inventory data collected in 1924, a majority of the forests in the broader region surrounding our focal site (82%) did not experience high levels of conifer competition. This is a stark contrast to contemporary forest conditions which showed that 73% of forests either were experiencing full site occupancy or were within the zone of imminent mortality. Contemporary forests not experiencing high levels of conifer competition had the highest density of large California black oak while forests in the zone of imminent mortality had the lowest density of large California black oak.

Conclusions

Fire exclusion and suppression led to a slow, albeit catastrophic, shift for California black oaks. The mixed conifer forests sampled in the early 1920s had very low tree densities and were dominated by large ponderosa and sugar pine trees which would have allowed California black oak to thrive. The number of very short fire intervals recorded is difficult to explain by lightning alone, pointing to the management of this area for Indigenous purposes. The 2021 wildfire resulted in 100% mortality of all conifer trees in the area but 61% of the California black oaks resprouted. This provides an opportunity to remove the conifer snags and allow the California black oaks to regain dominance. It would take active stewardship to produce the oak dominance again but it is possible and could be co-led by the Maidu and federal managers.
Mass flows and characteristic of mercury emitted from coal-fired power plant equipped with seawater flue gas desulphurization
Authors: Huang Mao Hung , Chen Wei Huan , Trinh Minh Man , Chang Moo Been
Published: March 2023

This study investigated the characteristics of mercury emitted from a large-scale coal-fired power plant in Taiwan via intensive sampling campaigns. The air pollution control devices equipped in this coal-fired power plant include selective catalytic reduction, fabric filter and seawater flue gas desulfurization. During three sampling campaigns, mercury concentrations emitted from this large-scale coal fired power plant ranged from 0.04 to 0.35 μg Nm−3. In addition, solid and liquid samples including coal, bottom ash, fly ash and inlet/outlet seawater were collected and analyzed for mercury content to provide the mass flows of mercury in this plant. The results indicate that mercury emitted from this coal-fired power plant is dominated by Hg0, and the emission factor of mercury ranges from 0.37 to 3.37 mg Hg t−1coal, which is relatively lower than those reported in other studies. The relative enrichment factor of mercury in fly ash (0.23–1.22) is significantly higher than that of bottom ash (0.10 × 10–3–0.89 × 10–3). Although this coal-fired power plant has a relatively low mercury atmospheric emission which accounts for 6.4% of the total mercury output, it is essential to further control mercury released from fly ash (62.6% of the total mercury output) and discharged seawater (33.7% of the total mercury output) to reduce environmental damage and human health effects.
Securing DNN for smart vehicles: an overview of adversarial attacks, defenses, and frameworks
Authors: Almutairi Suzan , Barnawi Ahmed
Published: March 2023

Recently, many applications have begun to employ deep neural networks (DNN), such as image recognition and safety-critical applications, for more accurate results. One of the most important critical applications of DNNs is in smart autonomous vehicles. The operative principles of autonomous vehicles depend heavily on their ability to collect data from the environment via integrated sensors, then employ DNN classification to interpret them and make operative decisions. The security and the reliability of DNNs raise many challenges and concerns for researchers. One of those challenges currently in the research domain is the threat of adversarial attacks on DNNs. In this survey, we present state-of-the-art research on DNN frameworks, adversarial attacks, and defenses. We discuss each work along with its advantages and limitations and present our thoughts on and future directions for adversarial attacks and defenses.
The effects of clay mineralogy and crack properties on elastic properties of dry and water-saturated transversely isotropic rocks
Authors: Gong Fei , Gao Liangliang , Zou Guangui , Zhao Yawei , Wang Guowei , Cao Song
Published: March 2023

The causes of the intrinsic elastic anisotropy of shales are very complicated, and clay mineralogy and crack properties are critical for rock-physics models and geomechanics applications in shales, but they are still poorly understood. Further, it is difficult to directly measure the elastic properties of single-crystal clays due to their small particle size. To reduce the multiparametric influence factors caused by complex components in natural shales, two sets of artificial rocks with different clay minerals are fabricated, and their porosity, permeability, and ultrasonic velocities are measured under different pressure conditions. The results suggest that clay mineralogy can significantly affect physical and elastic properties and their pressure sensitivity, and the permeabilities of the sample composed of kaolinite are much higher than those of the sample composed of smectite due to the larger particle size of kaolinite compared with smectite. Further, the type of clay can cause a difference in “intrinsic” velocity and anisotropy. The microcrack can enhance the velocity anisotropy on the basis of intrinsic anisotropy, and crack properties such as maximum dip angle and normal-to-tangential compliance ratio are obtained by a theoretical model, which is also affected by clay type, causing the difference in the pressure sensitivity of elastic properties. Water has a significant influence on the elastic properties and anisotropy of artificial clay samples, which can reduce the S-wave velocity and increase the P-wave velocity driven by multiple competing factors. Water reduces the velocity anisotropy because the presence of water narrows the difference between the velocity parallel and perpendicular to the axis of symmetry. The normal-to-tangential compliance ratio of cracks is also affected by water as a stiffer fluid can reduce the normal compliance of cracks at the grain scale.
Mental healthcare for adults with mild intellectual disabilities: population-based database study in Dutch mental health services
Authors: Pouls Katrien P. M. , Cuypers Maarten , Mastebroek Mathilde , Wieland Jannelien , Koks-Leensen Monique C. J. , Leusink Geraline L. , Assendelft Willem J. J.
Published: March 2023

Background

Adults with mild intellectual disability (MID) experience more mental health disorders than the general population. However, mental healthcare may be insufficiently tailored to match their needs. Detailed information is lacking regarding care provided to people with MID in mental health services.

Aims

To compare mental health disorders and care provided to patients with and without MID in Dutch mental health services, including patients with missing MID status in the service files.

Method

In this population-based database study, we used a Statistics Netherlands mental health service database, containing health insurance claims of patients who utilised advanced mental health services in 2015–2017. Patients with MID were identified by linking this database with Statistic Netherlands’ social services and long-term care databases.

Results

We identified 7596 patients with MID, of whom 60.6% had no intellectual disability registration in the service files. Compared with patients without intellectual disability (n= 329 864), they had different profiles of mental health disorders. They received fewer diagnostic (odds ratio 0.71, 95% CI 0.67–0.75) and treatment activities (odds ratio 0.56, 95% CI 0.53–0.59), and required more interprofessional consultations outside of the service (odds ratio 2.06, 95% CI 1.97–2.16), crisis interventions (odds ratio 2.00, 95% CI 1.90–2.10) and mental health-related hospital admissions (odds ratio 1.72, 95% CI 1.63–1.82).

Conclusions

Patients with MID in mental health services have different profiles of mental health disorders and care than patients without intellectual disability. In particular, fewer diagnostics and treatments are provided, especially in those with MID with no intellectual disability registration, putting patients with MID at risk of undertreatment and poorer mental health outcomes.
If Residential Segregation Persists, What Explains Widespread Increases in Residential Diversity?
Authors: Kye Samuel H. , Halpern-Manners Andrew
Published: March 2023

Recent studies have identified increasing residential diversity as a near-universal trend across the United States. At the same time, a wide range of scholarship notes the persistence of White flight and other mechanisms that reproduce residential segregation. In this article, we attempt to reconcile these findings by arguing that current trends toward increased residential diversity may sometimes mask population changes that are more consistent with racial turnover and eventual resegregation. Specifically, we show that increases in diversity occur nearly identically across neighborhoods where White populations remain stable or decline in the face of non-White population growth. Our findings demonstrate that, particularly in its early stages, racial turnover decouples diversity and integration, leading to increases in diversity without corresponding increases in residential integration. These results suggest that in many neighborhoods, diversity increases may be transitory phenomena driven primarily by a neighborhood's location in the racial turnover process. In the future, stalled or decreasing levels of diversity may become more common in these areas as segregation persists and the process of racial turnover continues.
The Virus Touch
Authors: Ghosh Bishnupriya
Published: March 2023

In The Virus Touch Bishnupriya Ghosh argues that media are central to understanding emergent relations between viruses, humans, and nonhuman life. Writing in the shadow of the HIV/AIDS and COVID-19 global pandemics, Ghosh theorizes “epidemic media” to show how epidemics are mediated in images, numbers, and movements through the processes of reading test results and tracking infection and mortality rates. Scientific, artistic, and activist epidemic media that make multispecies relations sensible and manageable eschew anthropocentric survival strategies and instead recast global public health crises as biological, social, and ecological catastrophes, pushing us toward a multispecies politics of health. Ghosh trains her analytic gaze on these mediations as expressed in the collection and analysis of blood samples as a form of viral media; the geospatialization of data that track viral hosts like wild primates; and the use of multisensory images to trace fluctuations in viral mutations. Studying how epidemic media inscribe, store, and transmit multispecies relations attunes us to the anthropogenic drivers of pathogenicity like deforestation or illegal wildlife trading and the vulnerabilities accruing from diseases that arise from socioeconomic inequities and biopolitical neglect.
The Autocratic Academy
Authors: Kaufman-Osborn Timothy V.
Published: March 2023

Critics of contemporary US higher education often point to the academy’s “corporatization” as one of its defining maladies. However, in The Autocratic Academy Timothy V. Kaufman-Osborn argues that American colleges and universities have always been organized as corporations in which the power to rule is legally vested in and monopolized by antidemocratic governing boards. This institutional form, Kaufman-Osborn contends, is antithetical to the free inquiry that defines the purpose of higher education. Tracing the history of the American academy from the founding of Harvard (1636), through the Supreme Court’s Dartmouth v. Woodward ruling (1819), and into the twenty-first century, Kaufman-Osborn shows how the university’s autocratic legal constitution is now yoked to its representation on the model of private property. Explaining why appeals to the cause of shared governance cannot succeed in wresting power from the academy’s autocrats, Kaufman-Osborn argues that American universities must now be reincorporated in accordance with the principles of democratic republicanism. Only then can the academy’s members hold accountable those chosen to govern and collectively determine the disposition of higher education’s unique public goods.
Utilization of Palliative Care Services Among Patients With Malignant Brain Tumors: An Analysis of the National Inpatient Sample (2016-2019)
Authors: Dullea Jonathan T. , Vasan Vikram , Devarajan Alex , Ali Muhammad , Nichols Noah , Chaluts Danielle , Henson Phil , Porras Christian , Lopez Christine , Luna Diego , Liou Lathan , Bederson Joshua , Shrivastava Raj K.
Published: March 2023

BACKGROUND:

Recent advances in treatment of malignant brain tumors have improved outcomes. However, patients continue to experience significant disability. Palliative care helps patients with advanced illnesses improve their quality of life. There is a paucity of clinical studies examining palliative care usage among patients with malignant brain tumors.

OBJECTIVE:

To assess if there were any patterns in palliative care utilization among patients hospitalized with malignant brain tumors.

METHODS:

A retrospective cohort representing hospitalizations for malignant brain tumors was created from The National Inpatient Sample (2016-2019). Palliative care utilization was identified by ICD-10 code. Univariable and multivariable logistic regression models, accounting for the sample design, were built to evaluate the demographic variables associated with palliative care consultation in all patients and fatal hospitalizations.

RESULTS:

375 010 patients admitted with a malignant brain tumor were included in this study. Over the whole cohort, 15.0% of patients used palliative care. In fatal hospitalizations, Black and Hispanic patients had 28% lower odds of receiving a palliative care consultation compared with White patients (odds ratio for both = 0.72; P = .02). For fatal hospitalizations, patients insured privately were 34% more likely to use palliative care services compared with patients insured with Medicare (odds ratio = 1.34, P = .006).

CONCLUSION:

Palliative care is underutilized among all patients with malignant brain tumors. Within this population, disparities in utilization are exacerbated by sociodemographic factors. Prospective studies investigating utilization disparities across race and insurance status are necessary to improve access to palliative care services for this population.
Approach Selection Strategies for Repeat Resection of Brain Cavernous Malformations: Cohort Study
Authors: Graffeo Christopher S. , Scherschinski Lea , Benner Dimitri , Devia Diego A. , Thomas George , Koester Stefan W. , Catapano Joshua S. , Winkler Ethan A. , Srinivasan Visish M. , Lawton Michael T.
Published: March 2023

BACKGROUND:

Neurosurgical management of cerebral cavernous malformations (CMs) often benefits from using skull base approaches. Although many CMs are cured by resection, residual or recurrent disease may require repeat resection.

OBJECTIVE:

To review approach selection strategies for reoperation of CMs to aid decision-making for repeat procedures.

METHODS:

In this retrospective cohort study, a prospectively maintained single-surgeon registry was queried for patients with CMs who underwent repeat resection from January 1, 1997, to April 30, 2021.

RESULTS:

Of 854 consecutive patients, 68 (8%) underwent 2 operations; 40 had accessible data on both. In most reoperations (33/40 [83%]), the index approach was repeated. In most reoperations using the index approach (29/33 [88%]), that approach was deemed ideal (no equivalent or superior alternative), whereas in some (4/33 [12%]), the alternative approach was deemed unsafe because of conformation of the tract. Among patients with reoperations using an alternative approach (7/40 [18%]), 2 with index transsylvian approaches underwent bifrontal transcallosal approaches, 2 with index presigmoid approaches underwent extended retrosigmoid revisions, and 3 with index supracerebellar-infratentorial approaches underwent alternative supracerebellar-infratentorial trajectory revisions. Among patients with reoperations with an alternative approach considered or selected (11/40 [28%]), 8 of 11 patients had a different surgeon for the index resection than for the repeat resection. The extended retrosigmoid-based approaches were used most often for reoperations.

CONCLUSION:

Repeat resection of recurrent or residual CMs is a challenging neurosurgical niche at the intersection of cerebrovascular and skull base disciplines. Suboptimal index approaches may limit surgical options for repeat resection.
The Roof of the 4th Ventricle Seen From Inside: Endoscopic Anatomic Illustration—A Case Series
Authors: Longatti Pierluigi , Feletti Alberto , Basaldella Luca , Boaro Alessandro , Sala Francesco , Fiorindi Alessandro
Published: March 2023

BACKGROUND:

The anatomy of the roof of the fourth ventricle has been illustrated in many laboratory investigations, but in vivo reports of the roof anatomy and its variants are still lacking.

OBJECTIVE:

To describe the topographical anatomy of the roof of the fourth ventricle explored through a transaqueductal approach that overcomes cerebrospinal fluid depletion, displaying in vivo anatomic images possibly quite close to normal physiological conditions.

METHODS:

We critically reviewed the intraoperative video recordings of our 838 neuroendoscopic procedures, selecting 27 cases of transaqueductal navigation that provided good quality image details of the anatomy of the roof of the fourth ventricle. Twenty-six patients affected by different forms of hydrocephalus were therefore categorized into three groups: Group A: blockage of the aqueduct-aqueductoplasty, Group B: communicating hydrocephalus, and Group C: tetraventricular obstructive hydrocephalus.

RESULTS:

Group A has shown what the roof of a normal fourth ventricle really looks like albeit the structures seemed overcrowded because of the narrow space. Images from groups B and C paradoxically allowed a more distinct identification of the roof structures flattened by ventricular dilation, making them more comparable with the topography traced on the laboratory microsurgical studies.

CONCLUSION:

Endoscopic in vivo videos and images provided a novel anatomic view and an in vivo redefinition of the real topography of the roof of the fourth ventricle. The relevant role of cerebrospinal fluid was defined and outlined, as well as the effects of hydrocephalic dilation on some structures on the roof of the fourth ventricle.
FZD2 regulates limb development by mediating β-catenin-dependent and -independent Wnt signaling pathways
Authors: Zhu Xuming , Xu Mingang , Leu N. Adrian , Morrisey Edward E. , Millar Sarah E.
Published: March 2023

Human Robinow syndrome (RS) and dominant omodysplasia type 2 (OMOD2), characterized by skeletal limb and craniofacial defects, are associated with heterozygous mutations in the Wnt receptor FZD2. However, as FZD2 can activate both canonical and non-canonical Wnt pathways, its precise functions and mechanisms of action in limb development are unclear. To address these questions, we generated mice harboring a single-nucleotide insertion in Fzd2 (Fzd2em1Smill), causing a frameshift mutation in the final Dishevelled-interacting domain. Fzd2em1Smill mutant mice had shortened limbs, resembling those of RS and OMOD2 patients, indicating that FZD2 mutations are causative. Fzd2em1Smill mutant embryos displayed decreased canonical Wnt signaling in developing limb mesenchyme and disruption of digit chondrocyte elongation and orientation, which is controlled by the β-catenin-independent WNT5A/planar cell polarity (PCP) pathway. In line with these observations, we found that disruption of FZD function in limb mesenchyme caused formation of shortened bone elements and defects in Wnt/β-catenin and WNT5A/PCP signaling. These findings indicate that FZD2 controls limb development by mediating both canonical and non-canonical Wnt pathways and reveal causality of pathogenic FZD2 mutations in RS and OMOD2 patients.
Pregnancy and Exercise in Mountain Travelers
Authors: Keyes Linda E. , Sanders Linda
Published: March 2023

Pregnant women are traveling to high altitude and evidence-based recommendations are needed. Yet, there are limited data regarding the safety of short-term prenatal high-altitude exposure. There are benefits to prenatal exercise and may be benefits to altitude exposure. Studies evaluating maternofetal responses to exercise at altitude found the only complication was transient fetal bradycardia, a finding of questionable significance. There are no published cases of acute mountain sickness in pregnant women, and data suggesting an increase in preterm labor are of poor quality. Current recommendations across professional societies are overly cautious and inconsistent. Non-evidence-based restrictions to altitude exposure can have negative consequences for a pregnant women's physical, social, mental, and economic health. Available data suggest that risks of prenatal travel to altitude are low. Altitude exposure is likely safe for women with uncomplicated pregnancies. We do not recommend absolute restrictions to high altitude exposure, but rather caution and close self-monitoring.
Rational Inattention: A Review
Authors: Maćkowiak Bartosz , Matějka Filip , Wiederholt Mirko
Published: March 2023

We review the recent literature on rational inattention, identify the main theoretical mechanisms, and explain how it helps us understand a variety of phenomena across fields of economics. The theory of rational inattention assumes that agents cannot process all available information, but they can choose which exact pieces of information to attend to. Several important results in economics have been built around imperfect information. Nowadays, many more forms of information than ever before are available due to new technologies, and yet we are able to digest little of it. Which form of imperfect information we possess and act upon is thus largely determined by which information we choose to pay attention to. These choices are driven by current economic conditions and imply behavior that features numerous empirically supported departures from standard models. Combining these insights about human limitations with the optimizing approach of neoclassical economics yields a new, generally applicable model. (JEL D83, D91, E71)
The Economics of Internal Migration: Advances and Policy Questions
Authors: Jia Ning , Molloy Raven , Smith Christopher , Wozniak Abigail
Published: March 2023

We review developments in research on within-country migration, focusing on internal migration in the United States. We begin by describing approaches to modeling individuals’ migration decisions and equilibrium outcomes across local areas. Next, we summarize evidence regarding the impact of migration on individuals’ outcomes, implications of migration for local labor market adjustment, and interactions between migration and housing markets. Finally, we discuss evidence on the efficacy of policies aimed at encouraging migration and conclude by highlighting important unanswered questions that are critical for informing migration-related policy. (JEL I23, I38, J31, J61, J62, R23, R38)
The Best of Both Worlds: Combining Randomized Controlled Trials with Structural Modeling
Authors: Todd Petra E. , Wolpin Kenneth I.
Published: March 2023

There is a long-standing debate about the extent to which economic theory should inform econometric modeling and estimation. This debate is particularly evident in the program/policy evaluation literature, where reduced-form (experimental or quasi-experimental) and structural modeling approaches are often viewed as rival methodologies. Reduced-form proponents criticize the assumptions invoked in structural applications. Structural modeling advocates point to the limitations of reduced-form approaches in not being able to inform about program impacts prior to implementation or about the costs and benefits of program designs that deviate from the one that was implemented. In this paper, we argue that there is a new emerging view of a natural synergy between these two approaches, that they can be melded to exploit the advantages and ameliorate the disadvantages of each. We provide examples of how data from randomized controlled trials (RCTs), the exemplar of reduced form practitioners, can be used to enhance the credibility of structural estimation. We also illustrate how the structural approach complements experimental analyses by enabling evaluation of counterfactual policies/programs. Lastly, we survey many recent studies that combine these methodologies in various ways across different subfields within economics. (JEL C21, C52, C53, H24, I38, J13, R38)
Book Review: Voting over a Distributed Ledger: An Interdisciplinary Perspective
Authors: Berg Chris
Published: March 2023

Chris Berg of RMIT University reviews “Voting over a Distributed Ledger: An Interdisciplinary Perspective” by Amrita Dhillon, Grammateia Kotsialou, Peter McBurney, and Luke Riley. The EconLit abstract of this book begins: “Considers the potential of a blockchain-based infrastructure for a decentralized online voting platform, exploring how electronic voting can improve accessibility and how blockchain can potentially overcome problems with centralized electronic voting systems.”
Determinantes do risco soberano pela ótica das agências de rating
Authors: Yamanari Cristina Yue , De Guimarães e Souza Gustavo José
Published: March 2023

Para ser considerado Grau de Investimento, um país deve ser classificado como tal por pelo menos duas das três grandes agências de classificação de risco: Standard & Poor's, Moody's e Fitch. Construído a partir dos critérios adotados por essas agências, o modelo padrão identifica que doze variáveis em comum entre as metodologias proprietárias respondem por mais de 90% da variação dos ratings soberanos, para qualquer das três agências. Foram utilizadas as notas atribuídas a 200 nações no período de 15 anos (2000 a 2014). A abertura financeira parece ser favorável ao soberano, e Fitch e Moody's aparentam ser mais benevolentes nas análises de países industrializados.
Elections, state-owned banks, and bank profitability in Brazil
Authors: Schwinden Garcia Alexandre , Meurer Roberto
Published: March 2023

This article looks for evidence about the political use of Brazilian commercial state-owned banks in electoral years and possible impacts on the profitability of these banks. In addition, it aims to test the hypothesis that publicly traded state-owned banks suffer from less political interference and, consequently, are less affected in terms of lower profitability in election years. It is found, at first, that years of federal and municipal elections do not impact the profitability of state-owned banks. However, when state-owned banks are segmented into groups of publicly traded and non publicly traded banks, electoral cycles harm the profitability of banks that are non publicly traded, confirming the possibility of the political use of non publicly traded state-owned banks. The results show that the listing of state-owned banks on the stock exchange may reduce the use of state-owned banks for political purposes.