bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conclusion
Authors: Lyons John D. 
Published: October 2023

Abstract
In conclusion we ponder the implications of the present study’s contention that Molière mocks and thus subverts the institution of marriage as it was enforced by Church and state. Two of the comedies are especially telling in this regard. The Misanthrope stands out in the Western tradition of comedy by not ending with the marriage of the man and woman protagonists. And Molière’s protagonist in Le Festin de pierre (Don Juan) makes a mockery of marriage by ‘marrying’ any woman who takes his fancy, thus emptying the institution (and religious sacrament) of all significance and power. Don Juan may be seen as a man exploiting women, and thus to be the antithesis of a ‘feminist’ hero. But another reading invites the question of whether in Molière’s play the character may represent a convergence of interests between the group labelled ‘libertines’ (and predominantly associated with historically male groups) and those seventeenth-century women who also protested against the institution of marriage. Does the Célimène of The Misanthrope not share with Don Juan a critique of marriage? And does she not seek to make courtship and free amorous interaction of men and women possible? Don Juan is also similar to many of Molière’s women characters in his use of irony to elude what he feels is the oppression of an institution enforced by males, here represented by the brothers of one of the women he has ‘married’.
Evaluation of National Anaesthetics Teaching in Undergraduate Medicine (ENATUM)
Authors: Kumar Prakrit R , Wicks Saskia K , Kumar Ranya V , Rottenberg Augustus , Mostafa Omar , Gavalas Manolis 
Published: October 2023

Abstract

Background
During a global pandemic where anaesthetists play a pertinent role in treating coronavirus 2019 (COVID-19), it is crucial to inspire medical students to consider a career in anaesthetics and perioperative care. Where anaesthetic skills are vital for all surgical foundation doctors, regardless of whether they have a rotation in anaesthetics, this study seeks to establish the current level of exposure to anaesthetics in the UK medical schools’ curriculum and evaluate if the current anaesthetic undergraduate curriculum is sufficient to prepare students to pass their exams and perform the duties expected of them as future junior doctors.

Methods
A 35-item structured questionnaire, registered at University College London Hospital Research & Development (R&D), was distributed amongst foundation doctors who had graduated from UK universities within the previous 3 years between August and October 2020.

Results
In total, 239 participants completed the questionnaire from 34 UK medical schools. Despite 90.0% of participants being allocated an ‘anaesthesia’ placement, 54.0% spent &lt;15 hours shadowing an anaesthetist throughout their medical school. Of participants, 38.5% agreed that their anaesthetic teaching was sufficient compared to teaching of other specialities, with 48.6% of students not satisfied with the teaching provided to meet anaesthetic learning outcomes set by The Royal College of Surgeons of England; 72.4% said they would have benefited from additional anaesthetic teaching, with 80.7% stating it would have increased understanding into the speciality; and 71.5% stated a short course in anaesthetics alongside undergraduate training would have been beneficial.

Conclusions
Our results demonstrate that there is a lack of standardization in undergraduate anaesthetics teaching nationally and an additional undergraduate anaesthetic teaching programme is required to increase understanding and provide further insight into anaesthetics.
Key messages: The emergence of the coronavirus 2019 (COVID-19) pandemic has halted undergraduate medical education, in particular perioperative medicine and surgery.Exposure to anaesthesia is already limited in the medical undergraduate curriculum, with a limited number of anaesthesia-themed foundation rotations available for junior doctors.Recent UK graduates feel that undergraduate anaesthetics education is inadequate at medical school, reporting a lack of confidence in applying undergraduate anaesthesia learning outcomes.Additional anaesthetic teaching and online teaching methods are suggested ways of improving the delivery of undergraduate anaesthetic education.Can a national, standardized anaesthetics teaching curriculum improve the undergraduate knowledge base of anaesthesia?
Development of photoreactive demineralized bone matrix 3D printing colloidal inks for bone tissue engineering
Authors: Hogan Katie J , Öztatlı Hayriye , Perez Marissa R , Si Sophia , Umurhan Reyhan , Jui Elysa , Wang Ziwen , Jiang Emily Y , Han Sa R , Diba Mani , Jane Grande-Allen K , Garipcan Bora , Mikos Antonios G 
Published: October 2023

Abstract
Demineralized bone matrix (DBM) has been widely used clinically for dental, craniofacial and skeletal bone repair, as an osteoinductive and osteoconductive material. 3D printing (3DP) enables the creation of bone tissue engineering scaffolds with complex geometries and porosity. Photoreactive methacryloylated gelatin nanoparticles (GNP-MAs) 3DP inks have been developed, which display gel-like behavior for high print fidelity and are capable of post-printing photocrosslinking for control of scaffold swelling and degradation. Here, novel DBM nanoparticles (DBM-NPs, ∼400 nm) were fabricated and characterized prior to incorporation in 3DP inks. The objectives of this study were to determine how these DBM-NPs would influence the printability of composite colloidal 3DP inks, assess the impact of ultraviolet (UV) crosslinking on 3DP scaffold swelling and degradation and evaluate the osteogenic potential of DBM-NP-containing composite colloidal scaffolds. The addition of methacryloylated DBM-NPs (DBM-NP-MAs) to composite colloidal inks (100:0, 95:5 and 75:25 GNP-MA:DBM-NP-MA) did not significantly impact the rheological properties associated with printability, such as viscosity and shear recovery or photocrosslinking. UV crosslinking with a UV dosage of 3 J/cm2 directly impacted the rate of 3DP scaffold swelling for all GNP-MA:DBM-NP-MA ratios with an ∼40% greater increase in scaffold area and pore area in uncrosslinked versus photocrosslinked scaffolds over 21 days in phosphate-buffered saline (PBS). Likewise, degradation (hydrolytic and enzymatic) over 21 days for all DBM-NP-MA content groups was significantly decreased, ∼45% less in PBS and collagenase-containing PBS, in UV-crosslinked versus uncrosslinked groups. The incorporation of DBM-NP-MAs into scaffolds decreased mass loss compared to GNP-MA-only scaffolds during collagenase degradation. An in vitro osteogenic study with bone marrow-derived mesenchymal stem cells demonstrated osteoconductive properties of 3DP scaffolds for the DBM-NP-MA contents examined. The creation of photoreactive DBM-NP-MAs and their application in 3DP provide a platform for the development of ECM-derived colloidal materials and tailored control of biochemical cue presentation with broad tissue engineering applications.
A linear energy transfer distributions computation method for inhomogeneous medium by using the water equivalent ratio approximation
Authors: Yan Nan , Wu Chao , Zhou Yun , Liao Wentao , Liu Junya , Pu Yuehu 
Published: October 2023

Abstract
Dose-averaged linear energy transfer (LET), LETd is widely used in proton therapy. Compared with analytical models, Monte Carlo (MC) simulations are more accurate in obtaining LETd distributions, but they are time-consuming. This study used the 3D LETd distributions of proton beam spots in water by MC simulations as a benchmark data set. Subsequently, by combining the water equivalent ratio of various human tissues, the 3D LETd distributions of clinical cases could be quickly obtained. Our method was applied to a single spot of 160 MeV proton beam in a water-bone phantom and a pelvic case. We also computed the 3D LETd distributions for multiple proton beam spots in the pelvic case and a lung case. The results of our method were compared with the results of MC simulations, demonstrating that our method can rapidly provide 3D LETd distributions of clinical cases with acceptable differences from MC simulations.
Digital creatives and digital engineers: entrepreneurial firms, institutional context, and the organization of innovation
Authors: Miozzo Marcela , Storz Cornelia , Casper Steven 
Published: October 2023

Abstract
The comparative capitalisms literature has developed an increasingly dynamic approach to conceptualizing capitalism variety, and has suggested mechanisms to explain shifts in institutional practices under the surface of formal stability of the institutional context. Less is known, however, about how new entrepreneurial firms engage with institutions to develop organizational arrangements needed to support their innovation activities. Such engagement with institutions can represent sources of heterogeneity within and across national institutional contexts, with incremental changes in practices resulting, in some instances, in major transformations in institutions over time. We draw on a study of fifty-three independent mobile games firms in the USA and Japan and the structures and processes used by these firms to develop innovative activities in their institutional context. Our research advances our understanding of organizational diversity and institutional change in two ways. First, our study identifies two new ‘variants’ of how entrepreneurial firms organize their innovation activities in their institutional context—digital creatives and digital engineers. Second, we characterize the mechanisms through which entrepreneurial firms engage and respond to institutions that support the establishment of these variants—defecting, intensifying, and positioning vis-à-vis large firms.
Fiscal Impoverishment in Rich Democracies
Authors: Schechtl Manuel , O’Brien Rourke L 
Published: October 2023

Abstract
This article introduces fiscal impoverishment as a framework for comparative poverty research. We invert standard analyses of welfare state policy and household poverty by focusing not on poverty alleviation but poverty creation and exacerbation. Using harmonized household survey data, we show how the income and payroll taxes most rich countries rely on to finance the public sector serve to push households (further) into poverty. We estimate that across rich democracies on average about one in four households in poverty are made poorer on net after taxes and transfers; with fiscal impoverishment levels ranging from &lt;10% in some countries to more than 70% in others, revealing extreme cross-national variation in how the pocketbooks of poor households are impacted by national tax and transfer policy. We go on to show that fiscal impoverishment does not track with standard measures of welfare state generosity but is instead largely determined by design of income tax systems, particularly a country’s relative reliance on (regressive) payroll taxes versus (progressive) income taxes. We consider the implications of fiscal impoverishment for assessing welfare state performance and for comparative poverty research.
Revisiting the Measurement of Digital Inclusion
Authors: Sharp Matthew 
Published: October 2023

Abstract
As it becomes increasingly clear how central digital transformation is to development, the need for clarifying concepts and for coming up with standardized and accurate measures for digital inclusion becomes more urgent. Focusing on the internet as a foundational technology, this paper sets out a framework of core components of digital inclusion—including access/use, quality of access/use, affordability, and digital skills. The paper then surveys the ways these components are currently measured in household and firm surveys and by international organizations. Building on simple descriptive analysis of data from a wide range of sources, the paper highlights some of the often-overlooked weaknesses of current measures, and suggests possible improvements. The paper argues that (a) metrics for certain core components of digital inclusion—including quality of access/use and digital skills—are relatively underdeveloped, (b) some questions on technology use and skills may need to be adapted to developing country settings, (c) more attention should be paid to within-country inequalities in statistics reported by international organizations, (d) currently available digital inclusion indices are not very useful, and (e) there is much potential in using big data methods to measure digital inclusion.
Tetraploidy in the Boettger’s dwarf clawed frog (Pipidae: Hymenochirus boettgeri) from the Congo indicates non-conspecificity with the captive population
Authors: Gvoždík Václav , Knytl Martin , Zassi-Boulou Ange-Ghislain , Fornaini Nicola R , Bergelová Barbora 
Published: October 2023

Abstract
Cytogenetics can be used as a tool to study the evolution of polyploidy and taxonomy. Here we focus on aquatic African pipids, dwarf clawed frogs (Hymenochirus). Our study reveals that dwarf clawed frogs, present for decades in captivity, are best referred to as Hymenochirus sp. instead of the commonly used name ‘H. boettgeri’ or sometimes ‘H. curtipes’. We present the first karyotype from a morphologically identified specimen of H. boettgeri with a known locality in the north-western Congo, which is tetraploid with 2n = 36. The captive Hymenochirus species has been found diploid in previous studies with different reported chromosome numbers; here we reveal 2n = 20A + 1B chromosomes. Our findings suggest that the tetraploid H. boettgeri karyotype evolved through fusion of two biarmed chromosomes and subsequent allotetraploidization, and is functionally diploid, similar to the origin of tetraploid clawed frogs in the subgenus Xenopus. We observed the stable presence of a single B chromosome in both sexes of our individuals from the captive population of Hymenochirus sp. However, additional investigation is necessary to clarify whether there is variation in the number of A and B chromosomes among populations, individuals, and/or tissues. Further research is also needed to understand the evolution and taxonomy of the genus Hymenochirus.
Are Histidine Kinases of Arbuscular Mycorrhizal Fungi Involved in the Response to Ethylene and Cytokinins?
Authors: Mongès Ayla , Yaakoub Hajar , Bidon Baptiste , Glévarec Gaëlle , Héricourt François , Carpin Sabine , Chauderon Lucie , Drašarová Lenka , Spíchal Lukáš , Binder Brad M. , Papon Nicolas , Rochange Soizic 
Published: October 2023

Signals are exchanged at all stages of the arbuscular mycorrhizal (AM) symbiosis between fungi and their host plants. Root-exuded strigolactones are well-known early symbiotic cues, but the role of other phytohormones as interkingdom signals has seldom been investigated. Here we focus on ethylene and cytokinins, for which candidate receptors have been identified in the genome of the AM fungus Rhizophagus irregularis. Ethylene is known from the literature to affect asymbiotic development of AM fungi, and in the present study, we found that three cytokinin forms could stimulate spore germination in R. irregularis. Heterologous complementation of a Saccharomyces cerevisiae mutant strain with the candidate ethylene receptor RiHHK6 suggested that this protein can sense and transduce an ethylene signal. Accordingly, its N-terminal domain expressed in Pichia pastoris displayed saturable binding to radiolabeled ethylene. Thus, RiHHK6 displays the expected characteristics of an ethylene receptor. In contrast, the candidate cytokinin receptor RiHHK7 did not complement the S. cerevisiae mutant strain or Medicago truncatula cytokinin receptor mutants and seemed unable to bind cytokinins, suggesting that another receptor is involved in the perception of these phytohormones. Taken together, our results support the hypothesis that AM fungi respond to a range of phytohormones and that these compounds bear multiple functions in the rhizosphere beyond their known roles as internal plant developmental regulators. Our analysis of two phytohormone receptor candidates also sheds new light on the possible perception mechanisms in AM fungi. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Access to Prenatal Care Among Patients With Opioid Use Disorder in Florida
Authors: Fryer Kimberly , Reid Chinyere N. , Elmore Amanda L. , Mehra Saloni , Carr Caitlynn , Salemi Jason L. , Cogle Christopher R. , Pelletier Claire , Pacheco Garrillo Maria , Sappenfield William S. , Marshall Jennifer 
Published: October 2023

OBJECTIVE:
To evaluate access to prenatal care for pregnant patients receiving medication for opioid use disorder (MOUD) under Medicaid coverage in Florida.

METHODS:
A cross-sectional, secret shopper study was conducted in which calls were made to randomly selected obstetric clinicians' offices in Florida. Callers posed as a 14-week-pregnant patient with Medicaid insurance who was receiving MOUD from another physician and requested to schedule a first-time prenatal care appointment. Descriptive statistics were used to report our primary outcome, the callers' success in obtaining appointments from Medicaid-enrolled physicians' offices. Wait time for appointments and reasons the physician offices refused appointments to callers were collected.

RESULTS:
Overall, 2,816 obstetric clinicians are enrolled in Florida Medicaid. Callers made 1,747 attempts to contact 1,023 randomly selected physicians' offices from June to September 2021. Only 48.9% of medical offices (n=500) were successfully reached by phone, of which 39.4% (n=197) offered a prenatal care appointment to the caller. The median wait time until the first appointment was 15 days (quartile 1: 7; quartile 3: 26), with a range of 0–55 days. However, despite offering an appointment, 8.6% of the medical offices stated that they do not accept Medicaid insurance payment or would accept only self-pay. Among the 60.6% of callers unable to secure an appointment, the most common reasons were that the clinician was not accepting patients taking methadone (34.7%) or was not accepting any new patients with Medicaid insurance (23.8%) and that the pregnancy would be too advanced by the time of the first available appointment (7.3%).

CONCLUSION:
This secret shopper study found that the majority of obstetric clinicians' offices enrolled in Florida Medicaid do not accept pregnant patients with Medicaid insurance who are taking MOUD. Policy changes are needed to ensure access to adequate prenatal care for patients with opioid use disorder.
Physiologic Effects of the Awake Prone Position Combined With High-Flow Nasal Oxygen on Gas Exchange and Work of Breathing in Patients With Severe COVID-19 Pneumonia: A Randomized Crossover Trial
Authors: Lehingue Samuel , Allardet-Servent Jérôme , Ferdani Anne , Hraeich Sami , Forel Jean-Marie , Arnal Jean-Michel , Prud’homme Eloi , Penaranda Guillaume , Bourenne Jeremy , Monnet Olivier , Gainnier Marc , Cantais Emmanuel 
Published: October 2023

OBJECTIVES:
To determine the effect of the awake prone position (APP) on gas exchange and the work of breathing in spontaneously breathing patients with COVID-19–associated acute hypoxemic respiratory failure (AHRF) supported by high-flow nasal oxygen.

DESIGN:
Prospective randomized physiologic crossover multicenter trial.

SETTINGS:
Four ICUs in Marseille, France.

PATIENTS:
Seventeen patients with laboratory-confirmed COVID-19 pneumonia and Pao
2/Fio
2 less than or equal to 300 mm Hg while treated with high-flow nasal cannula oxygen therapy.

INTERVENTIONS:
Periods of APP and semirecumbent position (SRP) were randomly applied for 2 hours and separated by a 2-hour washout period.

MEASUREMENTS AND MAIN RESULTS:
Arterial blood gases, end-tidal CO2. and esophageal pressure were recorded prior to and at the end of each period. Inspiratory muscle effort was assessed by measuring the esophageal pressure swing (∆PES) and the simplified esophageal pressure–time product (sPTPES). The other endpoints included physiologic dead space to tidal volume ratio (VD/VT) and the transpulmonary pressure swing. The APP increased the Pao
2/Fio
2 from 84 Torr (61–137 Torr) to 208 Torr (114–226 Torr) (p = 0.0007) and decreased both the VD/VT and the respiratory rate from 0.54 (0.47–0.57) to 0.49 (0.45–0.53) (p = 0.012) and from 26 breaths/min (21–30 breaths/min) to 21 breaths/min (19–22 breaths/min), respectively (p = 0.002). These variables remained unchanged during the SRP. The ∆PES and sPTPES per breath were unaffected by the position. However, the APP reduced the sPTPES per minute from 225 cm H2O.s.m–1 (176–332 cm H2O.s.m–1) to 174 cm H2O.s.m–1 (161–254 cm H2O.s.m–1) (p = 0.049).

CONCLUSIONS:
In spontaneously breathing patients with COVID-19–associated AHRF supported by high-flow nasal oxygen, the APP improves oxygenation and reduces the physiologic dead space, respiratory rate, and work of breathing per minute.
Second Hematologic Malignancies Associated With Primary Mediastinal Germ Cell Tumors
Authors: Aguiar-Bujanda David , Croissier-Sánchez Laura , Pérez-Cabrera Daniel , Galván-Ruiz Saray 
Published: October 2023

Background:
Studies addressing second hematologic malignancies (SHMs) in patients with primary mediastinal germ cell tumors (PMGCTs) are scarce. To better describe this phenomenon, we analyzed a large case series from a population-based registry.

Methods:
The Surveillance, Epidemiology, and End Results database was used to report the clinical characteristics and incidence of SHMs in patients with PMGCT.

Results:
Among 1297 PMGCTs, 27 cases (2.08%) of SHM were found, with a median latency period of 12 months (95% CI: 5-41). All SHM occurred in males, 20 of whom (74.1%) had a previous nonseminomatous tumor. Acute myeloid leukemia was the most frequent SHM, accounting for 13 cases, 4 of which were acute megakaryoblastic leukemia that occurred within 5 months of diagnosis. The median survival after the diagnosis of SHM was 6 months (95% CI: 2-41). The risk of SHM was significantly higher than expected for the reference population, with a standardized incidence ratio of 6.21 (95% CI: 3.31-10.62) and an absolute excess risk of 19.19 per 10,000 person-years.

Conclusions:
Patients with PMGCT are at a higher risk of developing SHMs than the general population, particularly acute myeloid leukemia. This risk ranges from synchronous diagnosis of acute megakaryoblastic leukemia to the later onset of other hematological disorders that might be related to PMGCT therapies. Our findings may help create follow-up schedules for patients with PMGCT and raise the level of suspicion surrounding this association.