bluuebunny/crossref_metadata_2025_split huggingface dataset:
On the need for an ecologically dimensioned medical humanities
Authors: Coope Jonathan 
Published: December 2020

Increasing calls from medical professionals and scholars suggest an urgent need for better and more widespread understandings of the ecological dimensions of health. Such calls have included: two recentLancetspecial commissions on impacts of climate change on health; and recognition by senior figures from the WHO and United Nations of relationships between human impacts on the natural world and disease pandemics, with some suggesting prevention of future pandemics may require a radical reassessment of modernity’s relationship with the natural world.Among the medical humanities as a whole, however, calls for better and more widespread understandings of the ecological dimensions of health have not always been as prominent, or urgently expressed, as they might be.This paper, which presumes there is an urgent need for better and more widespread understandings of the ecological dimensions of human health, draws on ecological public health and other models to propose an ecological re-visioning of our conceptions of health and medical humanities; and in ways that challenge some contemporary assumptions about health, well-being and the ‘good society’. Indeed, once we begin to heed what ecocritic Tim Morton terms ‘the ecological thought’, we may discover few areas of healthcare and the humanities remain untouched by its implications.With growing recognition that the fate of global human health and the fate of the biosphere are inextricably entwined, the project of a more ecologically dimensioned medical humanities appears both timely and urgent. Such a project may represent a significant opportunity for the medical humanities, and a significant responsibility.
Multiple, objectively measured sleep dimensions including hypoxic burden and chronic kidney disease: findings from the Multi-Ethnic Study of Atherosclerosis
Authors: Jackson Chandra L , Umesi Chizoba , Gaston Symielle A , Azarbarzin Ali , Lunyera Joseph , McGrath John A , Jackson II W Braxton , Diamantidis Clarissa J , Boulware Ebony , Lutsey Pamela L , Redline Susan 
Published: December 2020

Background
Poor sleep may contribute to chronic kidney disease (CKD) through several pathways, including hypoxia-induced systemic and intraglomerular pressure, inflammation, oxidative stress and endothelial dysfunction. However, few studies have investigated the association between multiple objectively measured sleep dimensions and CKD.

Methods

We investigated the cross-sectional association between sleep dimensions and CKD among 1895 Multi-Ethnic Study of Atherosclerosis Sleep Ancillary Study participants who completed in-home polysomnography, wrist actigraphy and a sleep questionnaire. Using Poisson regression models with robust variance, we estimated separate prevalence ratios (PR) and 95% CIs for moderate-to-severe CKD (glomerular filtration rate <60 mL/min/1.73 m
2
or albuminuria >30 mg/g) among participants according to multiple sleep dimensions, including very short (≤5 hours) sleep, Apnoea−Hypopnoea Index and sleep apnoea-specific hypoxic burden (SASHB) (total area under the respiratory event-related desaturation curve divided by total sleep duration, %min/hour)). Regression models were adjusted for sociodemographic characteristics, health behaviours and clinical characteristics.

Results
Of the 1895 participants, mean age was 68.2±9.1 years, 54% were women, 37% were white, 28% black, 24% Hispanic/Latino and 11% Asian. Several sleep metrics were associated with higher adjusted PR of moderate-to-severe CKD: very short versus recommended sleep duration (PR=1.40, 95% CI 1.06 to 1.83); SASHB (Box-Cox transformed SASHB: PR=1.06, 95% CI 1.02 to 1.12); and for participants in the highest quintile of SASHB plus sleep apnoea: PR=1.28, 95% CI 1.01 to 1.63.

Conclusions
Sleep apnoea associated hypoxia and very short sleep, likely representing independent biological mechanisms, were associated with a higher moderate-to-severe CKD prevalence, which highlights the potential role for novel interventions.
Fingerprinting the contribution of colored scalars to the $$H^+ W^- Z(\gamma )$$ vertex
Authors: Chakrabarty Nabarun , Chakraborty Indrani , Ghosh Dilip Kumar 
Published: December 2020

AbstractColor-octet scalars arise in various Grand Unification scenarios and also in other models of new physics. They are also postulated for minimal flavour violation. Purely phenomenological imprints of such scalars are therefore worth looking at. Motivated by this, we perform a complete one-loop calculation of the $$H^+ \rightarrow W^+ Z (\gamma )$$

H
+

→

W
+

Z

(
γ
)

decay in a two Higgs doublet model augmented by a color-octet $$SU(2)_L$$

S
U

(
2
)

L

scalar doublet. The computation is conveniently segregated into colorless and colored components. The color-octet part of the amplitude, being scaled by the color-factor, provides an overall enhancement to the form factors. Crucial constraints from perturbative unitarity, positivity of the scalar potential, oblique parameters, Higgs signal strengths and direct search of a charged Higgs and color-octet scalars are folded-in into the analysis. Sensitivity of the loop-induced $$H^+ \rightarrow W^+ Z (\gamma )$$

H
+

→

W
+

Z

(
γ
)

vertex to other model parameters is elucidated. Finally, the prospect of observing a loop-induced $$H^+ \rightarrow W^+ Z (\gamma )$$

H
+

→

W
+

Z

(
γ
)

interaction at the future hadronic collisions is also discussed.
Tourist Intentions to Visit or Revisit Archaeological Sites in Pakistan
Authors: Ashraf Jawaria , Ali Sumran , Nawaz Muhammad Asim , Ghufran Muhammad 
Published: December 2020

Abstract
This study contributes to the literature on archaeological tourism by investigating the impact of psychological distance on tourist’s continuity to visit or revisit the archaeological sites. Recent trends show tourist preferred to visit the natural beauty and modern art instead of archaeological sites. Archaeologist encounters a considerable amount of difficulties when they try to operate on economic and sites protection fronts simultaneously. This study has relied on construal level theory to determine the tourist intentions to visit or revisit the archaeological sites in different time contrast and social proximity with identity centrality and gender diversity. For this study, 868 responses were collected from tourists using a structured questionnaire and analysed by structural equation modelling. The study establishes the role of psychological distance, which offers a clear plan to the tourist to visit or revisit archaeological sites by understanding their religious, social, and historical connection to them. This research also provides a dynamic way of thinking for archaeologists, policy makers, and the managing institutions to assist the tourist to visit or revisit archaeological sites through using social ties and time-spans as unique alternatives. The notable findings of this study open the door for future research to bridge the economic and social aspects with site preservation and capacity parameters.
Esoteric Writing through Historical Allusions
Authors: Chiu Yi-hsuan 
Published: December 2020

Abstract
This paper investigates the poetry of Qu Xuanying, a literatus who remained in the city of Beiping (now Beijing) following its occupation by the Japanese in 1937. Through historical allusions in his poetry, Qu communicated with friends about the ethical dilemmas that he faced under occupation, and reflected upon the choices that literati in earlier eras had made when facing dynastic transitions and foreign conquest. Qu’s ‘esoteric writing’ during the occupation contained a complex set of historical allusions which referenced various points in the Chinese past. Since Qu served in the collaborationist north China regime, he has often been perceived as a ‘traitor’ or a ‘collaborator’. Through this in-depth analysis of his literary works, however, this paper seeks to reveal the special exegetical strategies adopted by literati such as Qu under occupation.
A Historian’s Ethical Duty
Authors: Yuan Yidan 
Published: December 2020

Abstract
In the wake of Japan’s occupation of Beiping (now Beijing) in 1937, the historian Chen Yuan’s choice between staying in or leaving the city (which would imply accommodation or resistance) was regarded not merely as a personal decision but also as a symbolic stance for the ethical principles of the Chinese intelligentsia. Based on a close reading of Chen’s historical writings during the Japanese occupation, this paper focuses on the inner world of this historian, and argues that a salient rhetorical feature of Chen’s wartime work was its role as a mechanism which he referred to as ‘illuminating the subtle’. This involved historical facts being cited and interpreted in a way that demonstrated the historian’s attitude and feelings towards contemporary events. It is proposed that the ‘illumination of the subtle’ is not accepted at face value as academic research, but rather that it is treated as a rhetorical device, in order to understand the inner logic and dynamism of this expressive mechanism.
Naming the Unnamable
Authors: Stock Wiebke-Marie 
Published: December 2020

Abstract
In On Divine Names the Christian neoplatonist Dionysius the Areopagite (~500 AD) develops a philosophical mode in which the form of the text follows from and advances his topic. This has not been recognized mostly because modern philosophical treatises have followed primarily the expository line of the text. However, Dionysius’ topic here, how properly to name God or as he would put it more broadly, how to praise God (hymnein), requires a technique of a certain indirection. In short, the reader cannot be led by argument alone to appropriate naming of the divine. Instead, the reader is led to a performative, almost liturgical philosophizing. This paper will consider in particular Dionysius’ opening chapters that serve to orient the reader to such a performative mode and to Dionysius’ modification of neoplatonic thinking on naming the divine.
The Academic Historiography of the Crusades and the Twenty-First Century Debate on Religious Violence
Authors: Cotts John D. 
Published: December 2020

Abstract
21st-century journalists, politicians, and terrorists have found the crusades to be a remarkably versatile point of reference when they consider religiously articulated violence in the modern world. This article will explore how recent academic historiography relates to and can better inform modern debates about geopolitics, the role of religion in political life, as well as the broader question of how scholars can meaningfully participate in those debates. Historians need to walk a fine line between taking religious experience seriously while also rejecting simple explanations that see religion as especially culpable in inspiring violence, and that portray such violence as an irrational return to the “medieval”. The various sections of the article provide a few key examples of recent controversies over religious violence, and situate both traditional and recent crusades historiography within a contemporary political context. It will be argued here that recent crusades scholarship has provided nuanced and dynamic accounts of crusading piety that can be used to reject simplistic explanations of religious violence as pre-modern, and as inherent in particular faith traditions.
PartialF8gene duplication (factor VIII Padua) associated with high factor VIII levels and familial thrombophilia
Authors: Simioni Paolo , Cagnin Stefano , Sartorello Francesca , Sales Gabriele , Pagani Luca , Bulato Cristiana , Gavasso Sabrina , Nuzzo Francesca , Chemello Francesco , Radu Claudia M. , Tormene Daniela , Spiezia Luca , Hackeng Tilman M. , Campello Elena , Castoldi Elisabetta 
Published: December 2020

AbstractHigh coagulation factor VIII (FVIII) levels comprise a common risk factor for venous thromboembolism (VTE), but the underlying genetic determinants are largely unknown. We investigated the molecular bases of high FVIII levels in 2 Italian families with severe thrombophilia. The proband of the first family had a history of recurrent VTE before age 50 years, with extremely and persistently elevated FVIII antigen and activity levels (&gt;400%) as the only thrombophilic defects. Genetic analysis revealed a 23.4-kb tandem duplication of the proximal portion of the F8 gene (promoter, exon 1, and a large part of intron 1), which cosegregated with high FVIII levels in the family and was absent in 103 normal controls. Targeted screening of 50 unrelated VTE patients with FVIII levels ≥250% identified a second thrombophilic family with the same F8 rearrangement on the same genetic background, suggesting a founder effect. Carriers of the duplication from both families showed a twofold or greater upregulation of F8 messenger RNA, consistent with the presence of open chromatin signatures and enhancer elements within the duplicated region. Testing of these sequences in a luciferase reporter assay pinpointed a 927-bp region of F8 intron 1 associated with &gt;45-fold increased reporter activity in endothelial cells, potentially mediating the F8 transcriptional enhancement observed in carriers of the duplication. In summary, we report the first thrombophilic defect in the F8 gene (designated FVIII Padua) associated with markedly elevated FVIII levels and severe thrombophilia in 2 Italian families.
Glucose-6-phosphate dehydrogenase deficiency and susceptibility to childhood diseases in Kilifi, Kenya
Authors: Uyoga Sophie , Macharia Alex W. , Ndila Carolyne M. , Nyutu Gideon , Shebe Mohammed , Awuondo Kennedy O. , Mturi Neema , Peshu Norbert , Tsofa Benjamin , Scott J. Anthony G. , Maitland Kathryn , Williams Thomas N. 
Published: December 2020

Abstract
Few previous studies have reported the effects of glucose-6-phosphate dehydrogenase (G6PD)–deficiency on child health in Africa. We conducted a case-control study in which cases (n = 6829) were children admitted, for any reason, to Kilifi County Hospital, Kenya, while controls (n = 10 179) were recruited from the surrounding community. Cases were subclassified based on their clinical and laboratory findings at admission. We calculated the prevalence of specific diseases by G6PD c.202 genotype, the only significant cause of G6PD-deficiency in this area, then estimated the association between genotype and admission with specific conditions using logistic regression. Among neonates, the prevalence of jaundice was higher in both G6PD c.202T heterozygotes (40/88; 45.5%; P = .004) and homo/hemizygotes (81/134; 60.5%; P &lt; .0001) than in wild-type homozygotes (157/526; 29.9%). Median bilirubin levels also increased across the groups, being highest (239 mmol/L; interquartile range 96-390 mmol/L) in G6PD c.202T homo/hemizygotes. No differences were seen in admission hemoglobin concentrations or the prevalence of anemia or severe anemia by G6PD c.202 genotype. On case control analysis, G6PD heterozygosity was negatively associated with all-cause hospital admission (odds ratio 0.81; 95% confidence interval 0.73-0.90; P &lt; .0001) and, specifically, admission with either pneumonia or Plasmodium falciparum parasitemia; while, conversely, it was positively associated with Gram-positive bacteremia. G6PD c.202T homo/heterozygosity was positively associated with neonatal jaundice, severe pneumonia, the receipt of a transfusion, and in-patient death. Our study supports the conclusion that G6PD c.202T is a balanced polymorphism in which a selective advantage afforded to heterozygous females against malaria is counterbalanced by increased risks of neonatal jaundice, invasive bacterial infections, and anemia.
Strategies for introducing palliative care in the management of relapsed or refractory aggressive lymphomas
Authors: Odejide Oreofe O. 
Published: December 2020

Abstract
Recent advances in treatment of patients with aggressive lymphomas ranging from chimeric antigen receptor T-cell therapy to combination of antibody–drug conjugates with chemotherapy have improved survival outcomes. Despite these significant advances, patients with relapsed or refractory disease experience high physical and psychological symptom burden, and a substantial proportion still die of their lymphoma. In addition, end-of-life care outcomes are suboptimal with high rates of intensive end-of-life health care use and low rates of timely hospice enrollment. Integrating palliative care concurrently with disease-directed care for this patient population has strong potential to improve their symptom burden, quality of life, and end-of-life care. Multiple factors, including heightened prognostic uncertainty in the setting of relapsed/refractory disease, pose challenges to timely provision of palliative care. This article reviews benefits of primary and specialty palliative care for patients with relapsed/refractory aggressive lymphomas and barriers to such care. It also highlights strategies for effectively integrating palliative care for patients with relapsed/refractory aggressive lymphomas.
Social aspects of chronic transfusions: addressing social determinants of health, health literacy, and quality of life
Authors: Webb Jennifer 
Published: December 2020

Abstract
Chronic monthly transfusions are a lifesaving preventative therapy for many patients with sickle cell disease; however, the burden of this therapy for patients and families is high. In the United States, there is overlap in the population affected by sickle cell disease and those with the greatest burden of social needs. Hematology providers caring for patients with SCD have an opportunity to screen for and mitigate social determinants of health, especially in those receiving chronic transfusion therapy given the frequent interactions with the healthcare system and increased demand on already potentially limited resources. Given the complexity of the treatment and medication regimens, providers caring for patients receiving chronic transfusions should implement universal strategies to minimize the impact of low health literacy, as this therapy imposes a significant demand on the health literacy skills of a family. Despite the social and literacy burden of this intervention, it is reassuring that quality of life is preserved as patients with SCD on chronic transfusion therapy often report higher health related quality of life than their peers receiving other disease modifying therapies.
Bispecifics, trispecifics, and other novel immune treatments in myeloma
Authors: Lancman Guido , Richter Joshua , Chari Ajai 
Published: December 2020

Abstract
Despite recent advances in treatment, relapses in multiple myeloma (MM) are inevitable. Off-the-shelf immunotherapeutics represent a promising avenue for research, with various classes of agents under development and several demonstrating deep and durable responses in patients who have exhausted all available therapies. Antibody-drug conjugates (ADCs) seek to improve on naked monoclonal antibodies by delivering a cytotoxic payload directly to tumor cells while largely limiting systemic effects. Belantamab mafodotin, a B-cell maturation antigen (BCMA)–targeted ADC, has shown response rates &gt;30% in a phase 2 trial of highly refractory patients and is being investigated in a variety of settings and combinations. Several other ADCs are in earlier stages of development that target cell surface antigens that are internalized, including BCMA, CD38, CD46, CD56, CD74, and CD138. Bispecifics are designed to bring cytotoxic immune effector cells into proximity with tumor cells, and several agents have shown high response rates in early trials. Current targets include BCMA, CD38, GPRC5d, and FCRH5, and all of these seek to engage T cells through CD3. Bispecifics targeting natural killer (NK) cells through CD16 are still in preclinical development. Trispecific antibodies may represent an advance over bispecifics by providing a T-cell costimulatory signal such as CD28, or alternatively, dual MM antigens to increase specificity of NK or T-cell targeting. This is an area of active preclinical research at this time. Lastly, designed ankyrin repeat proteins, which are small antibody-mimetic proteins with high target-binding affinity, have the potential to block multiple pathways at once and provide stimulatory signals to the immune system.
Future of CAR T cells in multiple myeloma
Authors: Wudhikarn Kitsada , Mailankody Sham , Smith Eric L. 
Published: December 2020

AbstractDespite the significant improvement in survival outcomes of multiple myeloma (MM) over the past decade, it remains an incurable disease. Patients with triple-class refractory MM have limited treatment options and a dismal prognosis. Chimeric antigen receptor (CAR) T-cell therapy targeting B-cell maturation antigen has transformed the treatment armamentarium of relapsed/refractory MM (RRMM), with unprecedented overall response rates in this difficult-to-treat patient population. However, a significant proportion of patients ultimately relapse despite achieving deep remission. Several innovative approaches, including alternative/dual-antigen–specific CAR T-cell constructs, genetically engineered “off-the-shelf” CAR T cells, and strategies to counteract an immunosuppressive microenvironment, may dramatically reshape the field of CAR T-cell therapy in the future. These strategies are being actively investigated in preclinical and early clinical trial settings with the hopes of enhancing the durability of responses and, thereby, improving the overall survival of RRMM patients after CAR T-cell therapy.
Preventing and monitoring for tumor lysis syndrome and other toxicities of venetoclax during treatment of chronic lymphocytic leukemia
Authors: Fischer Kirsten , Al-Sawaf Othman , Hallek Michael 
Published: December 2020

Abstract
Recent developments in the management of chronic lymphocytic leukemia (CLL) have moved the standard of care away from chemoimmunotherapy to targeted agents such as oral kinase inhibitors or BCL-2 antagonists, alone or in combination with anti-CD20 antibodies. Two different treatment approaches have evolved: continuous, indefinite treatment and, more recently, fixed-duration combination treatment. With venetoclax-based treatment, there is a requirement to follow the established guidelines for close monitoring during initiation and ramp up, to reduce the risk of tumor lysis syndrome. The patient’s risk should be assessed before the initiation of venetoclax. Appropriate management strategies should be used, including uricosuric agents, hydration, and routine laboratory monitoring, per guidelines. With early identification, immediate management, and dose adjustments, we suggest that tumor lysis syndrome and other toxicities, such as neutropenia and infections, with venetoclax-based treatment can be dealt with successfully.
A patient with Gaucher disease and plasma cell dyscrasia: bidirectional impact
Authors: Zimran Ari , Ruchlemer Rosa , Revel-Vilk Shoshana 
Published: December 2020

AbstractPatients with Gaucher disease (GD), a rare autosomal recessive glycosphingolipid storage disease, commonly present to hematologists with unexplained splenomegaly, thrombocytopenia, anemia, and bone symptoms. Patients with GD may develop other manifestations, such as autoimmune thrombocytopenia, monoclonal gammopathy, multiple myeloma, or, even more rarely, other hematological malignancies; sometimes they are first diagnosed during an assessment of those disorders. Although the diagnosis and management of patients with GD have significantly evolved over the last 30 years, some patients remain poor responders to GD-specific therapy, needing novel and investigational therapies. Ideally, patients with GD, like patients with other rare diseases, should be managed by a multidisciplinary team expert with the diverse clinical manifestations and potential GD-related or -unrelated comorbidities. The hematology community should be knowledgeable regarding the presentation and the variety of hematologic complications and comorbidities associated with Gaucher disease.