bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti‐natalism is incompatible with Theory X
Authors: Yoshizawa Fumitake 
Published: December 2023

AbstractThe anti‐natalist philosopher David Benatar defends a position asserting that all life is harmful, and that it is, therefore, wrong to have children. In this paper, I critique Benatar's less‐discussed claim that his anti‐natalism provides solutions to population ethics problems, such as the Non‐Identity Problem, the Repugnant Conclusion, and the Mere Addition Problem, all of which are presented in Derek Parfit's Reasons and Persons. Since the publication of his Better Never to Have Been, Benatar has continued to claim that its provision of such solutions strengthens his defense of anti‐natalism. Although Benatar's view has received much criticism, this argument has not been discussed at length. I undertake a thorough examination of the argument and identify reasons to reject it. The central point of my critique is that the implications of Benatar's views in determining ranges of wrong and not‐wrong cases of procreation are extensionally inadequate when applied to the problems of population ethics.
The metabolic basis of inherited neutropenias
Authors: Oyarbide Usua , Crane Genevieve M. , Corey Seth J. 
Published: December 2023

SummaryNeutrophils are the shortest‐lived blood cells, which requires a prodigious degree of proliferation and differentiation to sustain physiologically sufficient numbers and be poised to respond quickly to infectious emergencies. More than 107 neutrophils are produced every minute in an adult bone marrow—a process that is tightly regulated by a small group of cytokines and chemical mediators and dependent on nutrients and energy. Like granulocyte colony‐stimulating factor, the primary growth factor for granulopoiesis, they stimulate signalling pathways, some affecting metabolism. Nutrient or energy deficiency stresses the survival, proliferation, and differentiation of neutrophils and their precursors. Thus, it is not surprising that monogenic disorders related to metabolism exist that result in neutropenia. Among these are pathogenic mutations in HAX1, G6PC3, SLC37A4, TAFAZZIN, SBDS, EFL1 and the mitochondrial disorders. These mutations perturb carbohydrate, lipid and/or protein metabolism. We hypothesize that metabolic disturbances may drive the pathogenesis of a subset of inherited neutropenias just as defects in DNA damage response do in Fanconi anaemia, telomere maintenance in dyskeratosis congenita and ribosome formation in Diamond–Blackfan anaemia. Greater understanding of metabolic pathways in granulopoiesis will identify points of vulnerability in production and may point to new strategies for the treatment of neutropenias.
Telehealth services for children with neuro‐developmental disabilities in the Asia‐Pacific region: A systematic review
Authors: Devagiri Bhagya , Ariyasena Akila Dinethra K. , Siriwardhana Dhammika Deepani , Sumanasena Samanmali 
Published: December 2023

AbstractBackgroundIn recent years telehealth became a popular and a rational health service delivery approach, especially amidst multiple challenges posed while providing health care interventions during the COVID‐19 pandemic.AimWe synthesized available evidence on telehealth for managing children with NDDs in the Asia‐Pacific region with the aim of identifying successful methods.MethodologyWe systematically reviewed six electronic databases: MEDLINE, AMED, EMBASE, PsychInfo, Web of Science, and (CINAHL plus) using the keywords and database‐specific subject headings from their inception to 25th August 2021. Review findings were synthesized narratively, and harvest plots were used to demonstrate the effect of interventions. The protocol and reporting the findings of this review adhered to PRISMA 2020 guidelines. PROSPERO registration: CRD 340690.ResultsWe harvested 30,823 records; 17,563 duplicates were removed, and 196 full‐text articles were assessed for eligibility. 16 studies with multiple research designs were included in the review. Eight were from the Pacific region and eight represented Asia. The interventions targeted families and children with a variety of NDDs (autism spectrum disorder, Down syndrome, cleft lip and palate, hearing impairment, cerebral palsy etc.) via telehealth. Telehealth packages consisted of direct and indirect methods of synchronous, asynchronous, and hybrid approaches. All studies used parent‐led intervention strategies. Telehealth reported a positive effect in 7/16 studies while five showed a neutral effect.ConclusionsAccording to published evidence telehealth for children with NDDs is an evolving, evidence‐based service facilitation modality in the Asia‐Pacific region, with only a few published randomized controlled trials. The systematic review shows promising telehealth practices emerging across the region despite the diversity in NDDs studied.
Levothyroxine for a high‐normal TSH in unexplained infertility
Authors: Galbiati Francesca , Jokar Tahereh Orouji , Howell Lars M. , Li Runjia , Fourman Lindsay T. , Lee Hang , Jeong Jong‐Hyeon , Fazeli Pouneh K. 
Published: December 2023

AbstractObjectiveUnexplained infertility affects nearly one‐third of infertile couples. Women with unexplained infertility are more likely to have a high‐normal thyroid‐stimulating hormone level (TSH: 2.5–5 mIU/L) compared to women with severe male factor infertility. Practice guidelines vary on whether treatment should be initiated for TSH levels >2.5 mIU/L in women attempting conception because the effects of treating a high‐normal TSH level with levothyroxine are not known. We evaluated conception and live birth rates in women with unexplained infertility and high‐normal TSH levels.Design, Patients and MeasurementsRetrospective study including 96 women evaluated for unexplained infertility at a large academic medical centre between 1 January 2000 and 30 June 2017 with high‐normal TSH (TSH: 2.5–5 mIU/L and within the normal range of the assay) who were prescribed (n = 31) or not prescribed (n = 65) levothyroxine. Conception and live birth rates were assessed.ResultsThe conception rate in the levothyroxine group was 100% compared to 90% in the untreated group (p = .086 unadjusted; p < .05 adjusted for age; p = .370 adjusted for TSH; p = .287 adjusted for age and TSH). The live birth rate was lower in the levothyroxine group (63%) compared to the untreated group (84%) (p = .05 unadjusted; p = .094 adjusted for age; p = .035 adjusted for TSH; p = .057 adjusted for age and TSH).ConclusionsWomen with unexplained infertility and high‐normal TSH levels treated with levothyroxine had a higher rate of conception but lower live birth rate compared to untreated women, with the limitation of a small sample size. These findings assert the need for prospective, randomized studies to determine whether treatment with levothyroxine in women with unexplained infertility and high‐normal TSH is beneficial.
Grading pancreatic adenocarcinomas on fine needle aspiration cytology. The outstanding issues
Authors: Mallik Mrinmay Kumar , Qadan Laila Rafiq , Mohanty Asit Kumar , Alali Ali , Kapila Kusum 
Published: December 2023

AbstractObjectiveThe three‐tier grading scheme described in “The Papanicolaou Society of Cytopathology (PSC) System for reporting Pancreaticobiliary Cytopathology” (TPSCRPBC) which remained unchanged following the WHO Reporting System for Pancreaticobiliary Cytopathology (WRPBC) was evaluated on pancreatic adenocarcinomas (PACs) reported on endoscopic ultrasound‐guided fine needle aspiration cytology (EUS‐FNAC).MethodsThe Papanicolaou and May Grunwald Giemsa‐stained smears from 116 cases of PACs were graded using the three‐tier grading scheme laid down by TPSCRPBC/WRPBC. Cases exhibiting multiple grades were assigned primary, secondary and tertiary grades. Each case was assigned a grade score, either by adding the primary and secondary grades, by adding the primary and tertiary grades when the tertiary grade was 3 or by doubling the grade when only one grade existed. Necrosis was estimated semi‐quantitatively. The inter‐observer reproducibility in grading was evaluated using Kappa and Kendall's tau‐c. Correlations between the various grades, the stage of the tumour and the amount of necrosis were assessed using Spearman rho and Kendall's tau‐b.Results31.89% of cases showed one grade, and 68.11% showed at least two grades. 16.38% showed three grades. The two commonest grade scores were 3 and 5. The inter‐observer reproducibility for grading and grade scoring was satisfactory. A positive correlation was noted between the grades and the amount of necrosis. No significant correlation was found between the grades, grade scores and the stage of the tumours.ConclusionsThe TPSCRPBC/WRPBC grading scheme can be suitably applied to PACs with good inter‐observer reproducibility. Cases often show multiple grades in the same tumour.
Shifting hotspots: Climate change projected to drive contractions and expansions of invasive plant abundance habitats
Authors: Evans Annette E. , Jarnevich Catherine S. , Beaury Evelyn M. , Engelstad Peder S. , Teich Nathan B. , LaRoe Jillian M. , Bradley Bethany A. 
Published: December 2023

AbstractAimPreventing the spread of range‐shifting invasive species is a top priority for mitigating the impacts of climate change. Invasive plants become abundant and cause negative impacts in only a fraction of their introduced ranges, yet projections of invasion risk are almost exclusively derived from models built using all non‐native occurrences and neglect abundance information.LocationEastern USA.MethodsWe compiled abundance records for 144 invasive plant species from five major growth forms. We fit over 600 species distribution models based on occurrences of abundant plant populations, thus projecting which areas in the eastern United States (U.S.) will be most susceptible to invasion under current and +2°C climate change.ResultsWe identified current invasive plant hotspots in the Great Lakes region, mid‐Atlantic region, and along the northeast coast of Florida and Georgia, each climatically suitable for abundant populations of over 30 invasive plant species. Under a +2°C climate change scenario, hotspots will shift an average of 213 km, predominantly towards the northeast U.S., where some areas are projected to become suitable for up to 21 new invasive plant species. Range shifting species could exacerbate impacts of up to 40 invasive species projected to sustain populations within existing hotspots. On the other hand, within the eastern U.S., 62% of species will experience decreased suitability for abundant populations with climate change. This trend is consistent across five plant growth forms.Main ConclusionsWe produced species range maps and state‐specific watch lists from these analyses, which can inform proactive regulation, monitoring, and management of invasive plants most likely to cause future ecological impacts. Additionally, areas we identify as becoming less suitable for abundant populations could be prioritized for restoration of climate‐adapted native species. This research provides a first comprehensive assessment of risk from abundant plant invasions across the eastern U.S.
Feasibility and safety of per‐oral endoscopic septotomy for Killian‐Jamieson diverticulum: Case series with video
Authors: Tanaka Ippei , Shimamura Yuto , Inoue Haruhiro , Azuma Daisuke , Ushikubo Kei , Yamamoto Kazuki , Okada Hiroki , Kimoto Yoshiaki , Nishikawa Yohei , Owada Kaori , Tanabe Mayo , Onimaru Manabu 
Published: December 2023

Background and AimsKillian‐Jamieson diverticulum (KJD) is a relatively uncommon variant of pharyngoesophageal diverticula, distinct from the more prevalent Zenker diverticulum. However, literature on endoscopic management of KJD remains limited. This study aimed to elucidate the efficacy and safety of peroral endoscopic septotomy (POES) as a treatment approach for symptomatic KJD.MethodsIn this retrospective observational study, we investigated the outcomes of nine consecutive patients who underwent POES for KJD between January 2019 and May 2023. Follow‐up data of at least 2 months post‐treatment were analyzed. The primary outcome measure was the technical success rate of POES. Secondary outcomes encompassed the clinical success rate, defined as symptomatic improvement 2 months after POES, and the incidence of adverse events.ResultsAll patients presented with dysphagia, with a median symptom duration of 6 months (interquartile range [IQR]: 3–12 months). The median diverticulum size was 32 mm (IQR: 24–42 mm). The median duration of the operation time was 66 min (IQR: 60–109). A 100% technical success rate was achieved, with complete closure of the defect in all cases. There were no adverse events related to this treatment. The median hospitalization duration was 5 days (IQR: 4–6), and the clinical success rate was 88.9%. Follow‐up barium esophagograms exhibited significant improvement in the flow of the barium for all patients.ConclusionsDespite the relatively limited case volume, our findings underscore that POES is a safe and efficacious approach for managing symptomatic KJD.
Cx3cr1 deficiency interferes with learning‐ and direct current stimulation‐mediated neuroplasticity of the motor cortex
Authors: Gellner Anne‐Kathrin , Reis Janine , Fiebich Bernd L. , Fritsch Brita 
Published: December 2023

AbstractMicroglia are essential contributors to synaptic transmission and stability and communicate with neurons via the fractalkine pathway. Transcranial direct current stimulation [(t)DCS], a form of non‐invasive electrical brain stimulation, modulates cortical excitability and promotes neuroplasticity, which has been extensively demonstrated in the motor cortex and for motor learning. The role of microglia and their fractalkine receptor CX3CR1 in motor cortical neuroplasticity mediated by DCS or motor learning requires further elucidation. We demonstrate the effects of pharmacological microglial depletion and genetic Cx3cr1 deficiency on the induction of DCS‐induced long‐term potentiation (DCS‐LTP) ex vivo. The relevance of microglia–neuron communication for DCS response and structural neuroplasticity underlying motor learning are assessed via 2‐photon in vivo imaging. The behavioural consequences of impaired CX3CR1 signalling are investigated for both gross and fine motor learning. We show that DCS‐mediated neuroplasticity in the motor cortex depends on the presence of microglia and is driven in part by CX3CR1 signalling ex vivo and provide the first evidence of microglia interacting with neurons during DCS in vivo. Furthermore, CX3CR1 signalling is required for motor learning and underlying structural neuroplasticity in concert with microglia interaction. Although we have recently demonstrated the microglial response to DCS in vivo, we now provide a link between microglial integrity and neuronal activity for the expression of DCS‐dependent neuroplasticity. In addition, we extend the knowledge on the relevance of CX3CR1 signalling for motor learning and structural neuroplasticity. The underlying molecular mechanisms and the potential impact of DCS in rescuing CX3CR1 deficits remain to be addressed in the future.
Cerebral vascular and blood brain–barrier abnormalities in a mouse model of epilepsy and tuberous sclerosis complex
Authors: Guo Dongjun , Zhang Bo , Han Lirong , Rensing Nicholas R. , Wong Michael 
Published: December 2023

AbstractObjectiveTuberous sclerosis complex (TSC) is a genetic disorder, characterized by tumor formation in the brain and other organs, and severe neurological symptoms, such as epilepsy. Abnormal vascular endothelial growth factor (VEGF) expression may promote angiogenesis in kidney and lung tumors in TSC and has been identified in brain specimens from TSC patients, but the role of VEGF and vascular abnormalities in neurological manifestations of TSC is poorly defined. In this study, we investigated abnormalities in brain VEGF expression, cerebral blood vessel anatomy, and blood–brain barrier (BBB) structure and function in a mouse model of TSC.MethodsTsc1GFAPCKO mice were used to investigate VEGF expression and vascular abnormalities in the brain by Western blotting and immunohistochemical analysis of vascular and BBB markers. In vivo two‐photon imaging was used to assess BBB permeability to normally impenetrable fluorescently labeled compounds. The effect of mechanistic target of rapamycin (mTOR) pathway inhibitors, VEGF receptor antagonists (apatinib), or BBB stabilizers (RepSox) was assessed in some of these assays, as well as on seizures by video‐electroencephalography.ResultsVEGF expression was elevated in cortex of Tsc1GFAPCKO mice, which was reversed by the mTOR inhibitor rapamycin. Tsc1GFAPCKO mice exhibited increased cerebral angiogenesis and vascular complexity in cortex and hippocampus, which were reversed by the VEGF receptor antagonist apatinib. BBB permeability was abnormally increased and BBB‐related tight junction proteins occludin and claudin‐5 were decreased in Tsc1GFAPCKO mice, also in an apatinib‐ and RepSox‐dependent manner. The BBB stabilizer (RepSox), but not the VEGF receptor antagonist (apatinib), decreased seizures and improved survival in Tsc1GFAPCKO mice.SignificanceIncreased brain VEGF expression is dependent on mTOR pathway activation and promotes cerebral vascular abnormalities and increased BBB permeability in a mouse model of TSC. BBB modulation may affect epileptogenesis and represent a rational treatment for epilepsy in TSC.
Atomistic simulation of rolling contact fatigue behavior of a face‐centered cubic material (nickel)
Authors: Goswami Pragyan , Pal Snehanshu , Gupta Manoj 
Published: December 2023

AbstractThe atomic‐level fundamental understanding of the rolling contact fatigue (RCF) mechanism using molecular dynamics (MD) simulation is yet to be understood more clearly. In this paper, the atomistic behavior of the single‐crystal Ni is studied under dynamic rolling contact loading with the help of MD simulations at varying temperatures of the specimen. The deformed material is investigated using atomic strain analyses to evaluate the shear, volumetric strain distribution, and von Mises stress. Furthermore, dislocation and stacking–fault analyses are done to determine the deformation mechanism of the material with the oscillation cycles. Simulation studies infer that dislocation defects tend to increase with the temperature of the specimen logarithmically. The deformation majorly results in partial dislocations, indicating low stacking fault (SF) energy. The present work opens up a new field of study to understand the RCF mechanisms, which can provide the foundational work to understand other face‐centered cubic (FCC) materials.
The immune system in Down Syndrome: Autoimmunity and severe infections
Authors: Ramba Meredith , Bogunovic Dusan 
Published: December 2023

SummaryOver 200,000 individuals in the United States alone live with Down Syndrome (DS), the most common genetic disorder associated with intellectual disability. DS has a constellation of features across the body, including dysregulation of the immune system. Individuals with DS have both a higher frequency of autoimmunity and more severe infections than the general population, highlighting the importance of understanding the immune system in this population. Individuals with DS present with dysregulation of both the innate and adaptive immune systems. Elevated cytokine levels, increased type I and type II IFN signaling, a shift toward memory phenotypes in T cells, and a decrease in the size of the B‐cell compartment are observed in individuals with DS, which contribute to both autoinflammation and severe infections. Herein, we discuss the current knowledge of the immune system in individuals with Down Syndrome as well as ideas of necessary further investigations to decipher the mechanisms by which trisomy 21 leads to immune dysregulation, with the ultimate goal of identifying clinical targets to improve treatment.
Three patterns of symptom communication between patients and clinicians in the intensive care unit: A fieldwork study
Authors: Nyhagen Ragnhild , Egerod Ingrid , Rustøen Tone , Lerdal Anners , Kirkevold Marit 
Published: December 2023

AbstractAimTo describe different patterns of communication aimed at preventing, identifying and managing symptoms between mechanically ventilated patients and clinicians in the intensive care unit.DesignWe conducted a fieldwork study with triangulation of participant observation and individual interviews.MethodsParticipant observation of nine patients and 50 clinicians: nurses, physiotherapists and physicians. Subsequent individual face‐to‐face interviews with nine of the clinicians, and six of the patients after they had regained their ability to speak and breathe spontaneously, were fully alert and felt well enough to sit through the interview.FindingsSymptom communication was found to be an integral part of patient care. We identified three communication patterns: (1) proactive symptom communication, (2) reactive symptom communication and (3) lack of symptom communication. The three patterns co‐existed in the cases and the first two complemented each other. The third pattern represents inadequate management of symptom distress.ConclusionRecognition of symptoms in non‐speaking intensive care patients is an important skill for clinicians. Our study uncovered three patterns of symptom communication, two of which promoted symptom management. The third pattern suggested that clinicians did not always acknowledge the symptom distress.Implications for Patient CareProactive and reactive symptom assessment of non‐speaking patients require patient verification when possible. Improved symptom prevention, identification and management require a combination of sound clinical judgement and attentiveness towards symptoms, implementation and use of relevant assessment tools, and implementation and skill building in augmentative and alternative communication.ImpactThis study addressed the challenges of symptom communication between mechanically ventilated patients and clinicians in the intensive care unit. Our findings may have an impact on patients and clinicians concerned with symptom management in intensive care units.Reporting MethodWe used the consolidated criteria for reporting qualitative research.Patient ContributionA user representative was involved in the design of the study.