bluuebunny/crossref_metadata_2025_split huggingface dataset:
Дорога к утопии вымощена противоречиями: теоретическое осмысление принципа равенства
Authors: Сечин Даниил Сергеевич 
Published: August 2024

Идея суверенного равенства является основой функционирования современного международного права и аргументации в дискуссиях о нарушении права и его эффективности. Она отражена в основных правовых актах, однако на деле, прикрываясь ширмой равенства, сильные государства воздействуют на слабые, навязывая им свою волю. Методология исследования основана на изучении номоса равенства, то есть упорядоченности норм, существующей в правовом воображении. Номос формируется через различные контексты и институциональные структуры. Поместив номос в историческую ретроспективу, можно увидеть, как он менялся и откуда взял свое начало. Истоки идеи равенства восходят к языческим сообществам, где сформировались два глобальных видения порядка: плюралистичный космос и иерархичная вселенная. Христианские нарративы провозглашали всеобщее равенство и единение, но при этом они переняли видение порядка вселенной, которая выстраивала иерархию, исключающую «не таких». Постепенно произошло изменение парадигмального взгляда, и разум стал основой познания. С разумом пришла идея прогресса и цивилизации. Цивилизованность обещала наступление равенства, ведь люди с помощью разума могли достичь благ европейского мира и сравниться с ним. Однако она также несла в себе неравенство и дискриминацию. Но в ХХ веке глобальный нарратив, описывающий все право, стал исчезать из юридической дискуссии. Одновременно с этим появилось множество новых нарративов, деконструирующих идею глобального порядка. В итоге номос равенства наполнен противоречиями и используется лишь как инструмент влияния, так как неравенство и дискриминация существуют в нем в силу восприятия порядка как вселенной. В результате концепция суверенного равенства оказывается противоречивой и бессодержательной. Вызванный этим кризис науки и права разрешается изменением культуры и отрицанием порядка вселенной. Метамодернистское видение мира предполагает возможность переустройства правопорядка на основе космоса и возникновения гомогенных плюралистичных режимов, каждый из которых построен на собственной системе ценностей. Российский проект равенства может опираться на идеи религиозной философии и концепции всеединства В. С. Соловьева, основанной на любви. Такой отдаленный проект утопии наполняет бессодержательное понятие равенства определенными ценностями и идеями.
Cost-effectiveness analysis of acalabrutinib in treatment of patients with relapsed/refractory form of mantle cell lymphoma who previously received at least one line of therapy
Authors: Zyryanov S. K. , Dyakov I. N. 
Published: August 2024

Objective: to conduct a clinical and economic study of acalabrutinib for the treatment of adult patients with relapsed/refractory form of mantle cell lymphoma who previously received at least one line of therapy in the Russian Federation.Material and methods. Acalabrutinib and ibrutinib were considered as compared treatment options. Based on the adjusted indirect comparison, they were found to be comparable in terms of overall survival and progression-free survival. Therefore, a cost minimization analysis method was selected for the study. Based on results of ACE-LY-004 clinical trial a distributed survival model was developed. The model was used to calculate drug costs over a 3-year horizon. To explore uncertainty in the results of economic evaluations we conducted a sensitivity analysis. A number of patients in the hypothetical cohort who could be further treated with a less expensive drug was determined during a missed opportunity analysis. Both mean life years gained and mean progression-free life years were calculated too.Results. Based on simulations over a 3-year horizon, the mean life years gained were 2.45, and the mean progression-free life years were 1.75. The average costs of acalabrutinib therapy both over 1 year and in total over 3 years were 36.6% lower compared to ibrutinib. So, in the 1st year, the costs for acalabrutinib were 3,546,237,60 rubles, for ibrutinib – 5,591,391,00 rubles (a difference of 2,045,153,40 rubles). Using acalabrutinib for 3 years was associated with costs of 7,252,980,60 rubles compared to 11,435,852,60 rubles for ibrutinib (a decrease of 4,182,872,00 rubles). Univariate multi-way sensitivity analysis showed the robustness of modeling results to price fluctuations in the range ±10%. For a hypothetical cohort of 100 patients, using acalabrutinib instead of the more expensive ibrutinib within the same budget will provide therapy to additional 57 patients per year.Conclusion. The results of the study demonstrated that acalabrutinib compared to ibrutinib for the treatment of adult patients with relapsed/ refractory form of mantle cell lymphoma can reduce costs for the 1st year of therapy by 2,045,153,40 rubles (36.6%), and by 4,182,872,00 rubles (36.6%) for 3 years. Thus, acalabrutinib is the cost-saving option for previously treated adult patients with relapsed/refractory mantle cell lymphoma in the Russian Federation.
Étude de l’usage de l’épigraphe dans Le bec de canard, de Gilbert Sinoué
Authors: Dirhoussi Loubna 
Published: August 2024

Cet article s’assigne comme objectif d’étudier la pratique épigraphique dans Le bec de canard de Gilbert Sinoué et d’en analyser les enjeux esthétiques. Pour ce faire, cette contribution part de l’hypothèse que ladite pratique relève de l’esthétique de l’hétérogène qui imprime au texte une dynamique intérieure et y installe une intertextualité soucieuse de la richesse et de la variété des imaginaires culturels et littéraires. Cette pratique est aussi le signe d’une altérité textuelle et littéraire recherchée par l’auteur. Le roman de Sinoué précité s’avère être le lieu de rencontre de plusieurs textes, d’obédiences différentes. Ainsi cette contribution s’articulera-t-elle autour de deux axes : dans un premier lieu, nous fournirons quelques considérations théoriques sur l’intertextualité ; dans un second lieu, nous analyserons la pratique de l’épigraphe dans l’œuvre susmentionnée.
Assessment of Knowledge and Practice Regarding Disposal of Unused and Expired Drugs in Medical Professionals in a Tertiary Care Teaching Hospital in Eastern India: A Cross- Sectional, Questionnaire-based Study
Authors: Gangopadhyay Tanmoy , Chakraborty Arup , Kumar Subir , Banerjee Shritama , Khatua Dilip 
Published: August 2024

Background: Despite the effect of drugs on human body getting wide attention worldwide the effect of disposed drugs on the environment is largely neglected. Since the doctors working in a teaching hospital are the major stakeholder in ensuring proper and safe disposal of drugs their knowledge, attitude and practice regarding drug disposal was assessed in this study.Methods: A pre-validated questionnaire was given to the doctors working in a tertiary care teaching hospital through Google form from 1st June,2023 to 31st July 2023. Their responses were recorded in a Microsoft excel form and analyzed.
Results: It was observed that while buying medicines 87.5% of physicians check the date of expiry but only 78.9% do that while receiving physician’s sample from the medical representatives. Among the participants in this study 97.2% declared that medicines remain unused in their homes. In case of unused drugs, 45.8% donate them to patients or hospitals, and 29.2% throw them away with household garbage whereas in case of expired medicines majority (56.9%) throw them away. Among the participants 38.9% had never instructed their patients about the proper disposal methods.
Conclusion: To ensure proper drug disposal programs should be initiated to increase awareness about the danger of improper drug disposal not only in general population but in medical community also.
The impact of negative pressure wound therapy on surgical site infection rates in obese women following cesarean section: A systematic review and meta‐analysis
Authors: Arian Mahdieh , Kamali Azadeh 
Published: August 2024

Background & Aim: This study aims to assess the surgical site infection (SSI) rate in obese women undergoing C-sections, comparing negative pressure wound therapy (NPWT) and standard dressings.
Methods & Materials: In this systematic review and meta-analysis, databases including Science Direct, Medline/PubMed, Web of Science, Scopus, and Cochrane Library were searched for articles published up to January 2024. The selection criteria included randomized controlled trials and cohort studies comparing the effect of (NPWT) with standard dressings on wound complications in women with obesity undergoing C-sections. Data collection and analysis Pooled effect sizes were calculated using random effects models based on heterogeneity.
Results: Out of 20 included studies, 18 reported SSI rates, which included 9243 cases and showed that NPWT reduces the rate of SSIs in obese women undergoing C-section (RR: 0.8, 95% CI: 0.66–0.96, I2= 24.5%, P= 0.01). An in-depth examination of 13 high-quality studies, in which NPWT devices were used, reveals a pooled Mantel-Haenszel (M-H) Risk Ratio (RR) of 0.92 for Prevention- Reduction - Epithelialization- Vacuum- Environment- Negative pressure- Advanced (PREVENA) (95% CI: 0.67–1.26, I2= 0%, P= 0.6) and 0.76 for Pressure- Incision- Closed- Optimization (PICO) (95% CI: 0.44–1.33, I2= 15%, P= 0.05), with a significant difference among devices (P=0.05).
Conclusion: NPWT reduces the SSI rate in obese women undergoing C-sections, regardless of the type or device used. Economic evaluations are crucial to justify NPWT device costs against expenses for treating surgical infections, supporting its widespread use in infection prevention.
RELAÇÃO DE GALECTINA 4 E ADENOCARCINOMA DUCTAL PANCREÁTICO: UMA REVISÃO INTEGRATIVA
Authors: Gabriel Ykaro , Germano Joelson , Sibelly Viviane , Cavalcante Celina , Melgarejo Michelle 
Published: August 2024

RESUMO

O presente estudo tem como objetivo discutir a influência da Galectina-4 (Gal-4) na progressão do Adenocarcinoma Ductal Pancreático (PDAC). Foi utilizado o modelo de revisão integrativa, por meio da revisão de literatura, como abordagem metodológica. A Gal-4, uma proteína ligante de β-galactosídeo, desempenha um papel significativo no câncer pancreático. Expressa em vários tipos de câncer, incluindo colorretal, mama, gástrico, pulmonar e pancreático, a Gal-4 emerge como possível biomarcador e alvo terapêutico. A sua atuação no câncer colorretal, ao inibir a progressão, está em consonância com a sua função no adenocarcinoma ductal pancreático, onde exerce um papel de inibição na migração celular. Mecanismos envolvem modulação de vias Wnt/β-catenina e IL-6/NF-κB/STAT3. A expressão de Gal-4 correlaciona-se com interações célula-tumor e glóbulos vermelhos, indicando implicações na disseminação tumoral. Presente em lesões precursoras e pancreatite crônica, a Gal-4 destaca-se como marcador em estágios iniciais ou inflamatórios. Resultados de modelos e estudos clínicos oferecem insights valiosos referentes à expressão da Gal-4, seus efeitos nas vias de sinalização celular e possíveis correlações com parâmetros clínicos relevantes no contexto do PDAC. Investigações futuras devem elucidar mecanismos, interações e relevância clínica, fundamentando estratégias terapêuticas e diagnósticas eficazes no PDAC.

Palavras-Chave: Câncer, Galectinas, PDAC.
Far Cortical Locking Versus Standard Constructs for Locked Plate Fixation in the Treatment of Acute, Displaced Fractures of the Distal Femur
Authors: Lefaivre Kelly A. , Slobogean Gerard , O’Hara Nathan N. , O’Brien Peter J. ,   the Canadian Orthopaedic Trauma Society (COTS) Investigators
Published: August 2024

Background:
Fixation of distal femoral fractures remains a challenge, and nonunions are common with standard constructs. Far cortical locking (FCL) constructs have been purported to lead to improved fracture-healing as compared with that achieved with traditional locking bridge plates. We sought to test this hypothesis in a comparative effectiveness clinical trial.

Methods:
This randomized trial was performed across 16 centers and included adult patients with an AO/OTA type 33A or 33C distal femoral fracture that was suitable for bridging fixation. We excluded patients with periprosthetic fractures. Participants were randomly assigned to either FCL fixation or standard locking plate fixation. The primary outcome was a hierarchical composite of radiographic and clinical fracture-healing at 3 months after fixation. We estimated between-group differences with use of the win ratio approach. Secondary outcomes included radiographic healing, clinical fracture-healing, complications, reoperations, and health-related quality of life (Short Form-36 Health Survey Version 2 [SF-36] Physical Component Summary and Mental Component Summary scores) at 3, 6, and 12 months after fixation.

Results:
We randomly assigned 193 patients to treatment with either FCL screws (96 patients) or standard screws (97 patients). The study population had a mean age of 63.4 years, consisted predominantly of women (68%), and was well-balanced between AO/OTA 33A and 33C fractures. Based on 4,355 pairwise comparisons, the calculated win ratio was 1.18 (95% confidence interval [CI], 0.77 to 1.79; p = 0.45), indicating that patients assigned to FCL screws had better outcomes in 51% of the comparisons. Radiographic healing did not differ significantly between the groups (odds ratio, 1.36; 95% CI, 0.69 to 2.72; p = 0.38), nor did Function IndeX for Trauma (FIX-IT) scores (p = 0.41). There were no significant differences between the groups in terms of SF-36 Physical Component Summary scores at 3 months or in the change in scores at 12 months after fixation.

Conclusions:
In this multicenter randomized trial of adult patients with an AO/OTA type 33A or 33C distal femoral fracture, similar clinical and radiographic healing outcomes were observed in the FCL and standard fixation groups.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Ten-Year Follow-up of Posterior Decompression and Fusion Surgery for Thoracic Ossification of the Posterior Longitudinal Ligament
Authors: Ito Sadayuki , Nakashima Hiroaki , Segi Naoki , Ouchida Jun , Oishi Ryotaro , Yamauchi Ippei , Miyairi Yuichi , Morita Yoshinori , Ode Yukihito , Imagama Shiro 
Published: August 2024

Background:
We evaluated the clinical, functional, and quality of life (QoL) outcomes of surgical treatment of thoracic ossification of the posterior longitudinal ligament (T-OPLL).

Methods:
We retrospectively evaluated 51 patients followed for ≥10 years after posterior decompression and corrective fusion surgery for T-OPLL. The data collected included demographics, comorbidities, and pre- and postoperative symptoms. The Japanese Orthopaedic Association (JOA) score, numerical rating scale (NRS) for back and leg pain, and EuroQol-5 Dimension-5 Level (EQ-5D-5L) were used to assess neurological function, pain, and QoL. Imaging evaluations were conducted to assess changes in kyphotic angles and ossification progression.

Results:
A significant improvement was observed in the JOA score from preoperatively (3.7) to 2 years postoperatively (7.9) (p < 0.05); the score remained stable thereafter. The mean EQ-5D-5L score improved from 0.53 preoperatively to 0.68 at 10 years postoperatively (p < 0.001). NRS scores for back and leg pain decreased from 5.4 to 3.5 and 4.0 to 3.0, respectively, from preoperatively to 10 years (p < 0.001 for both). Radiographic outcomes showed changes in kyphotic angles and ossification areas, with no significant progression after 2 years. Fourteen (27.5%) of the patients experienced postoperative complications. Of these, 8 (15.7%) required reoperation, 6 (11.8%) in the perioperative period and 2 (3.9%) later. Four (7.8%) of the patients underwent additional surgeries for conditions including lumbar spinal canal stenosis and cervical OPLL. Nonetheless, physical function in all cases with postoperative complications or additional surgery remained stable over the decade.

Conclusions:
Surgical treatment of T-OPLL is effective in improving neurological function, QoL, and pain management over an extended period. The long-term outcomes of T-OPLL surgery revealed that, although cervical and lumbar spinal lesions led to reoperations, they did not affect QoL, and relative improvement was maintained even after 10 years.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Revisiting Differences in Fourth-Year Orthopaedic Away Rotation Opportunities and Fees Among Allopathic and Osteopathic Medical Students
Authors: Modica Anthony , Kazimierczak Adam , Klein Brandon J. , White Peter B. , Bitterman Adam D. , Cohn Randy M. 
Published: August 2024

Introduction:
Fourth-year away rotations are an important modifiable variable proven to increase students' opportunities to match into orthopaedic surgery. The purpose of this study was to determine differences in away rotation eligibility requirements and cost of rotation between allopathic and osteopathic students during the 2023 application cycle. Eligibility requirements and fees were then compared with the 2021 application cycle.

Methods:
A cross-sectional study was performed during the 2023 application cycle of all nonmilitary, Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery residency programs (n = 194). Each program's website, affiliated school of medicine's website, visiting student application service portal, and Residency Explorer tool were searched for eligibility criteria, associated rotation fees, and other rotation requirements. Two-sample Z tests for proportions were utilized to compare differences in programs with differing requirements for students based on academic degree type. Data were compared statistically with previously reported data from the 2021 application cycle.

Results:
In 2023, there were more programs that restricted osteopathic medical students from away rotations than programs that restricted allopathic medical students (12/194, 6.2% vs. 0/194, 0.0%; p < 0.001). All 12 programs were formerly ACGME-accredited before the integration into a single accreditation system. There was a decrease in the number of programs restricting osteopathic medical students from away rotations compared with the 2021 application cycle (18/194, 9.3% vs. 12/194, 6.2%; p = 0.254). Fees associated with away rotations ranged from $25 to $4,000 for both allopathic and osteopathic students. The number of programs that charged osteopathic medical students higher rotation fees than programs that charged allopathic students when compared with the 2021 application cycles decreased (1/194, 0.5% vs. 5/194, 2.6%; p = 0.049).

Conclusions:
While some programs continue to have away rotation eligibility requirements that prohibit osteopathic medical students from rotating, only one residency program currently charges osteopathic medical students a higher fee to rotate than allopathic medical students.
Nutritional Considerations in Hip and Knee Arthroplasty
Authors: Arapovic Avianna E. , Nham Fong H. , Darwiche Hussein , El-Othmani Mouhanad 
Published: August 2024

» Initial screening for malnutrition can be initiated with a fibrinogen-albumin ratio threshold <11.7.» Protein supplementation to goal (1.2-1.9 g/kg), along with essential amino acid augmented with beta-hydroxy-beta-methylbutyrate and resistance training have shown benefit, especially in sarcopenic patients.» Omega-3 and omega-6 polyunsaturated fatty acid supplementation has a strong antioxidant role and gain of muscle mass.» Supplementation with adenosine triphosphate and magnesium sulfate provides an avenue to decrease postoperative pain and opioid consumption.» Motivational interviewing and multidisciplinary teams to achieve preoperative weight loss >20 lbs in morbidly obese patients can decrease complication rates.
Geochemistry and clay mineralogy of shales in the Sulu Orogenic Belt, East China: suggestion for continental weathering during an Early Cretaceous hyperthermal interval
Authors: Wang Hailong , Wang Wenxia , Cao Peijing , Qin Min , Shao Yiqi , Li Shoujun , Miao Chunhui , Zhang Xiangyu 
Published: August 2024

ABSTRACT
Understanding past weathering–climate feedback mechanisms under greenhouse conditions has significance for guiding the development of climate mitigation strategies. The continental paleoweathering state of Early Cretaceous shales in the Sulu Orogenic Belt of East China during a hyperthermal interval related to oceanic anoxic event 1a (OAE1a) was investigated via geochemical and clay mineralogical analyses of shale samples. The resulting diagrams of ternary 15Al2O3–Zr–300TiO2 discrimination, Th/Sc and Zr/Sc show that the geochemical composition was mainly controlled by source composition. This is supported by observations of low Zr contents, high indexes of compositional variability (ICV; &gt; 1), and micropetrological characteristics. All samples showed narrow SiO2/Al2O3 and (Fe2O3 + MgO)/Al2O3 ranges that were within the predicted weathering trends of the ternary A-CN-K diagram, indicating that the shale geochemistry was not influenced by silicification and K-metasomatism. The chondrite-normalized rare-earth-element pattern suggests that all samples had the same felsic igneous parent rock. The geochemistry of whole rocks and their silicate fractions indicates that the shale had low chemical indexes of alteration (CIA) but high ICV values compared to post-Archean Australian Shale, indicating low sediment maturity and extremely weak chemical weathering in the source terrane and/or sedimentary basin under hot-dry conditions. Moreover, the clay minerals in the shale were mainly illite, suggesting low mineral weathering. Thus, during the OAE1a-related hyperthermal interval, chemical weathering was relatively weak in some mid-latitude arid inland areas. This may be mainly due to aridification decreasing water–rock reactions. Chemostratigraphic analysis suggests that the CIA, Ga/Rb, and Rb/Sr values of shales from the upper strata of the Yangjiazhuang and Shuinan formations were greater than those from lower strata. Moreover, the opposite trend in K2O/Al2O3 ratios was found. These indices suggest gradual increases in chemical weathering as the climate changed from hot-dry to warm-humid. In contrast, proxy indices of shale from the Zhifengzhuang Formation showed the opposite trend, suggesting a gradual decrease in chemical weathering as the climate changed from warm-humid to hot-dry. Considering the composition of the clay minerals, it is speculated that continental weathering was dependent on atmospheric humidity rather than temperature under the extreme greenhouse conditions, resulting in ineffective climate regulation by chemical weathering. This comprehensive study advances our understanding of the weathering–climate feedback mechanism under greenhouse regimes.