bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Future of the EU after Brexit, and Covid-19
Authors: Fabbrini Federico 
Published: December 2020

Abstract
This chapter reflects on the future of the EU after Brexit — as an entity of 27 member states (EU27). In dealing with a member state that had decided to leave, the EU27 proved able to stick together and jointly defend the common interests, including of its smaller member states. However, the EU27 have faced an increasing number of crises which have profoundly challenged their unity and resolve. Indeed, the subsequent crises shattering the EU — including the euro-crisis, the migration crisis, and the rule of law crisis — and climaxing with Covid-19 have exposed deep divisions among the EU27 and brought to the surface competing visions of the project of European integration. Three alternative ideas of what the EU is and ought to be are increasingly taking shape: a first that sees the EU as a polity, which requires solidarity and a communion of efforts towards a shared destiny; a second that sees the EU as a market, designed to enhance wealth through commerce, but with as limited redistribution as possible; and a third which instead sees the EU as a vehicle to entrench state authoritarian rule, based on national identity and sovereignty claims, but with crucial transnational financial support. While these alternative visions often coexist within each state, they have increasingly become hallmarks of states, or blocs thereof, which are openly facing each other in the EU arena.
Particularities of Moral Lives
Authors: Christensen Anne-Marie Søndergaard 
Published: December 2020

Abstract
The chapter presents a critique of the idea that morality is impersonal and an investigation of how and to what extent personal features of our lives may be morally relevant and shape us as moral agents. In doing so, the chapter explains why moral life resists theorisation of the form criticised in Chapter 2, and it provides a better understanding of the challenges involved in developing a form of moral philosophy that can take the particularities of moral life into consideration. The chapter opens with a clarification of the approach and the central concepts of chapters 5 and 6, before turning to two suggestions of how to account for the personal dimension of moral life in terms of agent-relativity and strong moral self-definition. As these suggestions are shown to be inadequate, this leads to an investigation of the role of personal particularities in the moral formation and the moral positions of individuals. The centrality of the personal in moral life furthermore creates a demand on the subject to engage in justification in relation to others and self-understanding in relation to oneself, where self-understanding in many cases is to be understood as a process of both self-discovery and self-determination; of striving to settle both who one is and who one wants to be.
Particularities of Moral Contexts
Authors: Christensen Anne-Marie Søndergaard 
Published: December 2020

Abstract
We can only become competent moral thinkers by engaging in our community, but even if our communal practices and language in this way provide us with the resources necessary for moral thought, they may also be the source of moral bias, distortion, and corruption, a problem which is explored in this chapter with the aim of understanding the connection between moral thought and moral context. In opening, the chapter addresses the question of whether the embeddedness of the moral subject in a particular context or community challenges the possibility of moral responsibility, but its main part is devoted to the question of how context influences our moral thought and responsibility. An investigation of cases of changes in language use and linguistic practices demonstrates how we face a twofold moral responsibility, both for what we say and do and for the practices in which these sayings and doings are embedded. A further discussion of moral practices leads to the insight that even if particular practices can inhibit or distort moral thought, they cannot make certain moral thoughts or judgements inaccessible to us. Nonetheless, even if we in principle may think any moral thought in any context, context still greatly influences what thoughts we have reason to think, making some moral insights readily accessible while hiding or marginalising others. This again points to a general moral responsibility for critical moral reflection on context.
The Metaphysics of Original Sin
Authors: Rea Michael C. 
Published: December 2020

Abstract
This chapter argues that there is no straightforward conflict between the doctrine of original sin (construed as including the doctrine of original guilt) and the following thesis, which is taken to be the primary source of philosophical objection to that doctrine: (MR) A person P is morally responsible for the obtaining of a state of affairs S only if S obtains (or obtained) and P could have prevented S from obtaining. After surveying a variety of different construals of the doctrine of original sin, the chapter shows that the main source of tension with MR is the further assumption that no human being who was born after the commission of first sin could have done anything to prevent that first sin; and no human being who is born corrupt could have done anything to prevent her own corruption. The chapter then discusses different ways in which this assumption might be resisted.
The Transformational Role of Technology
Authors: Treadgold Alan , Reynolds Jonathan 
Published: December 2020

Abstract
This chapter focuses on the transformational impacts of technology both in the hands of shoppers and within retail enterprises themselves. There are, we believe, very compelling opportunities for businesses to develop much closer and more personal relationships with shoppers through the use of technology in customer-facing roles to enhance efficiency, experience, and engagement for the shopper. However, the challenges for enterprises of actually realizing all of the potential benefits from technology, especially in the form of highly nuanced shopper information, are considerable. This chapter is as concerned with the unexpected eddies as it is with the main transformational currents of technology change. It begins with a brief exploration of the main themes of change, then turns to some of the obstacles that have prevented many retailers from intelligently exploring technological opportunities, before considering the most relevant application areas for customer-facing technology.
“Epitome of America”
Authors: Abzug Robert H. 
Published: December 2020

Abstract
Rollo May was born and raised in what once was considered the American heartland, the small-town Protestant Midwest. However, his family life was extremely troubled. His father was a YMCA field secretary and his mother a devout Methodist who had a stormy and ultimately dysfunctional family life. Rollo sought escape in nature and tried to fulfil especially his mother’s sense of her son’s destiny. He was shy, resentful of his family’s relative poverty, and felt caught between the battles his father and mother constantly waged. Still, he saw his future in “religious work” and being a “friend to man.”
Interspecific variation in spruce constitutive and induced defenses in response to a bark beetle–fungal symbiont provides insight into traits associated with resistance
Authors: Ott Daniel S , Davis Thomas Seth , Mercado Javier E 
Published: December 2020

Abstract
Differences in defensive traits of tree species may predict why some conifers are susceptible to bark beetle–fungal complexes and others are not. A symbiotic fungus (Leptographium abietinum (Peck) M.J. Wingf.) associated with the tree-killing bark beetle (Dendroctonus rufipennis Kirby) is phytopathogenic to host trees and may hasten tree decline during colonization by beetles, but defense responses of mature trees to the fungus have not been experimentally examined. To test the hypothesis that interspecific variation in spruce resistance is explained by defense traits we compared constitutive (bark thickness and constitutive resin ducts) and induced defenses (resin flow, monoterpene composition, concentration, phloem lesion formation and traumatic resin ducts) between two sympatric spruces: Engelmann spruce (Picea engelmannii Parry ex Engelm.—a susceptible host) and blue spruce (Picea pungens Engelm.—a resistant host) in response to fungal inoculation. Four central findings emerged: (i) blue spruce has thicker outer bark and thinner phloem than Engelmann spruce, which may restrict fungal access to phloem and result in less beetle-available resource overall; (ii) both spruce species induce monoterpenes in response to inoculation but blue spruce has higher constitutive monoterpene levels, induces monoterpenes more rapidly, and induces higher concentrations over a period of time consistent with spruce beetle attack duration; (iii) Engelmann and blue spruce differed in the monoterpenes they upregulated in response to fungal inoculation: blue spruce upregulated α-pinene, terpinolene and γ-terpinene, but Engelmann spruce upregulated 3-carene and linalool; and (iv) blue spruce has a higher frequency of constitutive resin ducts and produces more traumatic resin ducts in annual growth increments than Engelmann spruce, though Engelmann spruce produces more resin following aseptic wounding or fungal inoculation. These findings suggest that higher constitutive resin duct densities and monoterpene concentrations, as well as the ability to rapidly induce specific monoterpenes in response to L. abietinum inoculation, are phenotypic traits associated with hosts resistant to spruce beetle colonization.
Actinomycetoma laboratory-based diagnosis: a mini-review
Authors: Siddig Emmanuel Edwar , van de Sande Wendy W J , Fahal Ahmed Hassan 
Published: December 2020

AbstractMycetoma is a chronic granulomatous inflammatory disease that is caused either by fungi (eumycetoma) or bacteria (actinomycetoma). The latter is caused by various actinomycetes of the genera Nocardia, Streptomyces and Actinomadura. They have different geographical distributions within mycetoma-endemic regions. In parts of Latin America, Nocardia species are more often encountered while in Africa, Streptomyces species dominate. For instituting a proper patient treatment plan, accurate identification of the causative organism is vital. For actinomycetoma, different laboratory-based techniques have been developed during recent decades. These include direct microscopy, cytology, histopathology and serology. More recently, different molecular techniques and matrix-assisted laser desorption ionisation-time of flight mass spectrometry have been included as diagnostic methods for actinomycetoma. In this review, an update on the laboratory techniques currently in use for the identification of actinomycetoma-causative agents to the species level is presented.
The Association of Scoliosis and NSD1 Gene Deletion in Sotos Syndrome Patients
Authors: Machida Masafumi , Katoh Hiroyuki , Machida Masayoshi , Miyake Atsushi , Taira Katsuaki , Ohashi Hirofumi 
Published: December 2020

Study Design
A retrospective comparative study.

Objective
The aim of this study was to examine the NSD1 abnormalities in patients diagnosed with Sotos syndrome and its correlation with the presence, severity, and progression of associated scoliosis.

Summary of Background Data
Scoliosis has been reported in approximately 30% of patients diagnosed with Sotos syndrome, a genetic disorder characterized by a distinctive facial appearance, learning disability, and overgrowth. Sotos syndrome is mainly attributed to NSD1 haploinsufficiency, but with ethnical differences in genetic profile: NSD1 microdeletions are frequently identified in Japanese Sotos patients whereas intragenic mutations are more frequently found in non-Japanese patients. Although possible genotype–phenotype correlations have been proposed, the genotype of Sotos syndrome patients suffering from scoliosis has not been examined.

Methods
The medical records and spinal radiographs of 63 consecutive Sotos syndrome patients at a single center were reviewed. Fluorescent in situ hybridization or microarray comparative genomic hybridization and DNA sequencing or multiplex ligation-dependent probe amplification were performed to detect 5q35 microdeletion involving the NSD1 gene and intragenic mutations of the NSD1 gene, respectively. The phenotypes of all cases and radiological assessments for the presence and progression of scoliosis were studied.

Results

NSD1 abnormalities were identified in 55 patients (87%): microdeletion in 34 patients (54%) and intragenic mutation in 22 patients (33%). Scoliosis was observed in 26 patients (41%), with a significantly higher ratio of microdeletions than mutations. The 10 patients with progressive scoliosis all had NSD1 microdeletions.

Conclusion
Scoliosis was a common phenotypical trait in children with Sotos syndrome and its presence as well as progression were higher in cases with NSD1 microdeletions. Although all Sotos syndrome patients should be monitored for scoliosis, clinicians should be made aware that patients with NSD1 microdeletions have a higher probability of scoliosis development and progression that may require early intervention.

Level of Evidence: 3
Nationwide Outcomes of Advanced Melanoma According to BRAFV600 Status
Authors: van Breeschoten Jesper , Wouters Michel W.J.M , de Wreede Liesbeth C. , Hilarius Doranne H. , Haanen John B. , Blank Christian U. , Aarts Maureen J.B , van den Berkmortel Franchette W.P.J. , de Groot Jan-Willem B. , Hospers Geke A.P. , Kapiteijn Ellen , Piersma Djura , van Rijn Rozemarijn S. , Suijkerbuijk Karijn P.M. , Blokx Willeke A.M. , ten Tije Albert J. , van der Veldt Astrid A.M. , Vreugdenhil Gerard , Boers Marye J. , van den Eertwegh Alfons J.M. 
Published: December 2020

Objective:
The aim of this study was to evaluate treatment patterns and overall survival (OS) of patients with BRAFV600 wild-type and BRAFV600-mutant advanced melanoma in the Netherlands.

Methods:
We selected patients of 18 years and over, diagnosed between 2016 and 2017 with unresectable stage IIIC or IV melanoma, registered in the Dutch Melanoma Treatment Registry. To assess the association of BRAFV600-mutation status with OS we used the Cox proportional-hazards model.

Results:
A total of 642 BRAFV600 wild-type and 853 mutant patients were included in the analysis. Median OS did not differ significantly between both groups, 15.2 months (95% confidence interval [CI]: 13.2-19.2) versus 20.6 months (95% CI: 18.3-25.0). Survival rates at 6 and 12 months were significantly lower for BRAFV600 wild-type patients compared with BRAFV600-mutant patients, 72.0% (95% CI: 68.6-75.6) and 56.0% (95% CI: 52.2-60.0) versus 83.4% (95% CI: 80.9-85.9) and 65.7% (95% CI: 62.6-69.0). Two-year survival was not significantly different between both groups, 41.1% (95% CI: 37.2-45.3) versus 47.0% (95% CI: 43.6-60.6). Between 0 and 10 months, BRAFV600 wild-type patients had a decreased survival with a hazard ratio for OS of 2.00 (95% CI: 1.62-2.46) but this effect disappeared after 10 months. At 12 months, BRAFV600-mutant patients had started with second-line systemic treatment more often compared with BRAFV600 wild-type patients (50% vs. 19%).

Conclusion:
These results suggest that advanced BRAFV600 wild-type melanoma patients have worse survival than BRAFV600-mutated patients during the first 10 months after diagnosis because of less available treatment options.
ICU preparedness in pandemics: lessons learned from the coronavirus disease-2019 outbreak
Authors: Harris Gavin , Adalja Amesh 
Published: December 2020

Purpose of review
The worldwide SARS-CoV-2 pandemic has taken a heavy toll on ICUs worldwide. This review expounds on lessons learned for ICU preparedness during the pandemic and for future mass casualty events.

Recent findings
In the 21st century, there have already been several outbreaks of infectious diseases that have led to mass casualties creating ICU strain, providing multiple opportunities for hospitals and hospital systems to prepare their ICUs for future events. Unfortunately, the sheer scale and rapidity of the SARS-CoV-2 pandemic led to overwhelming strain on every aspect of ICU disaster preparedness. Yet, by analyzing experiences of hospitals throughout the first 7 months of the current pandemic in the areas of infection control, equipment preparedness, staffing strategies, ICU spatial logistics as well as acute and postacute treatment, various important lessons have already emerged that will prove critical for successful future ICU preparedness.

Summary
Preemptive planning, beginning with the early identification of staffing resources, supply chains and alternative equipment sources, coupled with strong infection control practices that also provide for the flexibility for evolving evidence is of utmost importance. However, there is no single approach that can be applied to every health system.
Three metachronous primary lung cancers in a chronic smoker
Authors: Damania Dushyant , Chow Lillian , Betancourt Boris , Mahoney James , Haseeb M.A. , Jabbar Absia , Gupta Raavi , Sidhu Gurinder 
Published: December 2020

Abstract

Rationale:
Lung cancer is a leading cause of cancer-related deaths. Smoking is major risk factor for initial and subsequent lung cancer especially in active smokers. Treatment of subsequent lung cancer depends on whether it is synchronous or metachronous. We report a rare case of triple metachronous lung cancer and review of literature of patients with triple metachronous cancers. This will be the second case reported of triple metachronous lung cancer.

Patient concerns:
A 60-year-old male, active smoker with diabetes mellitus, chronic obstructive pulmonary disease (COPD) and peripheral arterial disease presented with cough and hemoptysis. Initial computed tomography (CT) scan showed right upper lobe spiculated mass.

Diagnosis:
He underwent transthoracic needle biopsy for right upper lobe mass, showing primary lung adenocarcinoma (ADC)-Stage-IIIA. He continued to smoke and 9-years later had new left upper lobe spiculated nodule, which on surgical resection showed squamous cell carcinoma (SCC)-Stage-IA1. Despite counselling on smoking cessation, he was unable to quit. Six months later, he presented with shortness of breath and CT chest showing right hilar adenopathy in right upper and lower lobes. He underwent transbronchial biopsies of lesion which showed small cell lung carcinoma (SCLC).

Interventions:
His initial lung ADC-Stage-IIIA, was treated with chemotherapy, weekly thoracic radiation and additional chemotherapy cycles. Nine years later, his left upper lobe mass showing SCC-Stage-IA1 was deemed curative after apical resection and he was kept on surveillance. Six months later, after diagnosis of SCLC in right upper and lower lobe, patient was not a candidate for systemic chemotherapy due to poor performance status and opted for hospice care.

Outcomes:
His initial lung ADC-Stage-IIIA showed complete radiological response with chemotherapy and radiation. Subsequent SCC-Stage-IA1 was deemed curative after resection. Due to his poor performance status, he was not a candidate for chemotherapy for SCLC and patient opted for hospice care.

Lessons:
Smoking is a major risk factor for developing lung cancer and with continued smoking, patients are at higher risk for developing subsequent primary lung cancers. We recommend, patients with lung cancer must quit smoking, and those who do not, should remain on long-term surveillance.
Diagnostic value of microRNA-25 in patients with non-small cell lung cancer in Chinese population
Authors: Li Chang , Sun Lin , Zhou Hongbin , Yang Ying , Wang Yong , She Min , Chen Jianguo 
Published: December 2020

Abstract

Objective:
Previous studies have shown that microRNA-25 (miR-25) plays a key role in the occurrence and development of non-small cell lung cancer (NSCLC). Many studies have shown that there is a significant increment of miR-25 in circulating blood of patients with NSCLC. The meta-analysis aims to explore diagnostic value of miR-25 in NSCLC in Chinese population.

Methods:
PubMed, Web of science, Excerpta Medica Database, China national knowledge infrastructure and China Wanfang database were searched to collect studies upon correlation between miR-25 and diagnosis of the patients with NSCLC until April 2020. Combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under receiver operating characteristic curve were calculated by Stata 15.0 software. Literature assessment was conducted according to quality assessment of diagnostic accuracy studies, and documents with scores above or equal to 11 were included in this meta-analysis.

Results:
Six studies were included, including 480 cases with NSCLC and 451 healthy controls. The combined sensitivity (0.75, 95% confidence interval [CI]: 0.69∼0.80), specificity (0.81, 95% CI: 0.76∼0.86), positive likelihood ratio (4.04, 95% CI: 3.14∼5.20), negative likelihood ratio (0.31, 95% CI: 0.25∼0.37), diagnostic odds ratio (13.09, 95% CI: 9.37∼18.29) and area under curve (0.85, 95% CI: 0.82∼0.88) indicated that miR-25 had desirable diagnostic accuracy for NSCLC.

Conclusion:
MiR-25 can be applied in diagnosis of NSCLC and has potential of becoming a biomarker for detection of patients with early NSCLC in Chinese population.
Kikuchi's disease with hemophagocytic lymphohistiocytosis
Authors: Duan Wei , Xiao Zheng-Hui , Yang Long-Gui , Luo Hai-Yan 
Published: December 2020

Abstract

Introduction:
Kikuchi's disease (KD) is a rare form of necrotizing lymphadenitis that rarely occurs in association with hemophagocytic lymphohistiocytosis (HLH) in children.

Patient concerns:
We report the case of a 4-year-5-month-old boy who suffered from fever, cervical lymphadenopathy, pancytopenia, hypertriglyceridemia, splenomegaly, low NK cell activity.

Diagnoses:
A diagnosis of KD with HLH was made based on the results of biopsy of cervical lymph node and HLH-2004 trial guidelines.

Interventions:
The patient was treated with corticosteroids, cyclosporine, etoposide, continuous hemodiafiltration (HDF), and plasma exchange (PE).

Outcomes:
He showed a complete response to therapy, and his condition gradually improved. He was discharged on day 45 after admission due to his good recovery status.

Conclusion:
HLH can be associated with KD, especially in childhood, and may have an aggressive clinical course. Continuous HDF and PE and chemotherapy should be reserved for those patients who fail to respond to IVIG and corticosteroids.