bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current Concerns About Gender-Affirming Therapy in Adolescents
Authors: Levine Stephen B. , Abbruzzese E. 
Published: April 2023

Abstract

Purpose of Review
Results of long-term studies of adult transgender populations failed to demonstrate convincing improvements in mental health, and some studies suggest that there are treatment-associated harms. The purpose of this review is to clarify concerns about the rapid proliferation of hormonal and surgical care for the record numbers of youth declaring transgender identities and seeking gender reassignment procedures.

Recent Findings
Systematic reviews of evidence conducted by public health authorities in Finland, Sweden, and England concluded that the risk/benefit ratio of youth gender transition ranges from unknown to unfavorable. As a result, there has been a shift from “gender-affirmative care,” which prioritizes access to medical interventions, to a more conservative approach that addresses psychiatric comorbidities and psychotherapeutically explores the developmental etiology of the trans identity. Debate about the safety and efficacy of “gender-affirming care” in the USA is only recently emerging.

Summary
The question, “Do the benefits of youth gender transitions outweigh the risks of harm?” remains unanswered because of a paucity of follow-up data. The conclusions of the systematic reviews of evidence for adolescents are consistent with long-term adult studies, which failed to show credible improvements in mental health and suggested a pattern of treatment-associated harms. Three recent papers examined the studies that underpin the practice of youth gender transition and found the research to be deeply flawed. Evidence does not support the notion that “affirmative care” of today’s adolescents is net beneficial. Questions about how to best care for the rapidly growing numbers of gender-dysphoric youth generated an intensity of divisiveness within and outside of medicine rarely seen with other clinical uncertainties. Because the future well-being of young patients and their families is at stake, the field must stop relying on social justice arguments and return to the time-honored principles of evidence-based medicine.
Antimony Potassium Tartrate Stabilizes Wide-Bandgap Perovskites for Inverted 4-T All-Perovskite Tandem Solar Cells with Efficiencies over 26%
Authors: Hu Xuzhi , Li Jiashuai , Wang Chen , Cui Hongsen , Liu Yongjie , Zhou Shun , Guan Hongling , Ke Weijun , Tao Chen , Fang Guojia 
Published: April 2023

AbstractWide-bandgap (WBG) perovskites have been attracting much attention because of their immense potential as a front light-absorber for tandem solar cells. However, WBG perovskite solar cells (PSCs) generally exhibit undesired large open-circuit voltage (VOC) loss due to light-induced phase segregation and severe non-radiative recombination loss. Herein, antimony potassium tartrate (APTA) is added to perovskite precursor as a multifunctional additive that not only coordinates with unbonded lead but also inhibits the migration of halogen in perovskite, which results in suppressed non-radiative recombination, inhibited phase segregation and better band energy alignment. Therefore, a APTA auxiliary WBG PSC with a champion photoelectric conversion efficiency of 20.35% and less hysteresis is presented. They maintain 80% of their initial efficiencies under 100 mW cm−2 white light illumination in nitrogen after 1,000 h. Furthermore, by combining a semi-transparent WBG perovskite front cell with a narrow-bandgap tin–lead PSC, a perovskite/perovskite four-terminal tandem solar cell with an efficiency over 26% is achieved. Our work provides a feasible approach for the fabrication of efficient tandem solar cells."Image missing"
The 1789 Christmas Eve collision of the HMS Guardian with an iceberg in the southwest Indian Ocean
Authors: Martin Seelye 
Published: April 2023

AbstractIn the evening of 24 December 1789, 2100 km southeast of Cape Town and after encountering three icebergs, the HMS Guardian under Captain Edward Riou collided with the submerged foot of a large iceberg. Despite severe damage to the ship and its abandonment by many of its crew and passengers, Riou sailed the hulk back to Cape Town, arriving on 22 February 1790. From present-day research and field studies, the formation of the foot in the collision is consistent with the above-freezing seawater temperatures inferred from Riou's commentary. Further, the observed 60 m iceberg height suggests that it calved from the Filchner Ice Shelf in the Weddell Sea. Comparison of the positions of Riou's icebergs with historic sightings, satellite observations and iceberg drift and fracture models also shows that they originated in the Weddell Sea and that their likelihood of occurrence in the collision region is small.
Legal theory in search of social transformation
Authors: Kampourakis Ioannis 
Published: April 2023

AbstractInspired by the contributions of Poul Kjaer and Kerry Rittich to this Special Issue, this article extends the reflection on the role and potential of law for social transformation. More specifically, I attempt to build on a revised framing of the constitutive role of law to draw the contours of a transformative instrumentalism, where law functions as an instrument for the articulation of political and social objectives. My account shifts the attention from transformative law’s form to its content, based on the premise that engagement with ‘political’ economy necessarily entails an engagement with the substantive standards that shape social relations of production and define the nature and extent of exploitation. Yet, I argue that the endorsement of law’s constitutive function and the turn to law’s content need not lead to the kind of instrumentalism that exhausts itself in particular policy reforms or prescriptions to assume control over processes of legal coding. Relying on a tentatively redrawn conception of the constitutive role of law that draws from both legal institutionalism and Marxist perspectives, I suggest that instrumentalism may instead be transformative by prioritising material ends, leaving open the question of the concrete legal and institutional forms that will materialise them. The directions of such transformative instrumentalism involve an element of ‘mobilisational democracy’ against the insulation of the economy from democratic control; reforms generative of collective subjects and centres of democratic power (‘non-reformist reforms’); and a focus on the planning and coordinating function of law among diverse – but united in their objective – legal rationales and institutional forms.
In search of a European economic imaginary of competition: fifty years of the Commission’s annual reports
Authors: Brook Or 
Published: April 2023

AbstractThe term ‘competition’ is a core notion for social and economic thinking and the organisation of markets. Nevertheless, this paper shows that there is no single acceptable economic imaginary ascribed to the notion in Europe. The search for the meaning of competition is an ongoing journey, from the EU’s very inception 60 years ago to the present day, which is inherently tied to the objectives, scope, and boundaries of EU (competition) law and to socio-economic transformations.The paper first reviews the history of the notion in both common-usage language and in legal-economic thinking. It exposes the emergence of three parallel, partly conflicting, imaginaries influencing the notion in EU competition law: Keynesian, ordoliberal, and neoliberal. After demonstrating that no single imaginary was adopted by EU primary, secondary, or soft laws, it applies Critical Discourse Analysis to the Commission’s annual reports on competition (1971–2020) in search for the meaning of competition. The paper reveals that the notion of competition had acquired one meaning in ‘hard’ contexts of the enforcement (scope of the prohibition of competition; exceptions or justifications for allowing otherwise anti-competitive behaviour), and another meaning in ‘softer’ contexts (mandates of the competition rules, and to a lesser extent – selection of enforcement priorities). While the ‘hard’ contexts have experienced a transformation from Keynesian and ordoliberal imaginary of competition to a neoliberal notion; the ‘soft’ contexts still invoke a broader notion reflecting influences from all three theories.Finally, the paper argues that although the lack of a clear definition for competition undoubtedly raises challenges relating to the rule of law, legal certainty, and uniformity, its ambiguity also serves as a powerful tool in safeguarding the durability and legitimacy of competition as an economic imaginary. It allows tailoring the notion of competition to changing legal, economic, and social conditions without a Treaty amendment.
Contracts scholarship beyond Materialisierung
Authors: Caruso Daniela 
Published: April 2023

AbstractThis comment aims to show how Klaus Eller's paper on ‘The Political Economy of Tenancy Contract Law’1 raises the stakes of private law scholarship and contributes to the larger project of remodeling legal institutions in a progressive direction. The comment starts by contextualising the rapid spread of the Law and Political Economy (LPE) movement; illustrates through examples the generative impact of LPE on contemporary contracts scholarship; and highlights two strands of Eller’s original contribution to such literature: a welcome reflection on the value and limits of Materialisierung, and a radical widening of the private law inquiry to include institutional dimensions of legal reform. The point of fostering such new directions is not to ditch the very logic of private law and its endogenous mechanisms of justice, which are still essential to progressive legal work. What is no longer tenable is to keep seeking socially oriented solutions exclusively within the private law arsenal of possibilities, even when it has become obvious that only a synergic approach can produce accurate diagnoses of – and perhaps cures for – the structural predicaments of the market economy.
REDD1 deletion and treadmill running increase liver hepcidin and gluconeogenic enzymes in male mice
Authors: Barney David E. , Gordon Bradley S. , Hennigar Stephen R. 
Published: April 2023

Abstract
The iron-regulatory hormone hepcidin is transcriptionally up-regulated by gluconeogenic signals. Recent evidence suggeststhat increases in circulating hepcidin may decrease dietary iron absorption following prolonged exercise, however evidence is limited on whether gluconeogenic signals contribute to post-exercise increases in hepcidin. Mice with genetic knockout of regulated in development and DNA response-1 (REDD1) display greater glycogen depletion following exercise, possibly indicating greater gluconeogenesis. The objective of the present study was to determine liver hepcidin, markers of gluconeogenesis and iron metabolism in REDD1 knockout and wild-type mice following prolonged exercise. Twelve-week-old male REDD1 knockout and wild-type mice were randomised to rest or 60 min treadmill running with 1, 3 or 6 h recovery (n = 5–8/genotype/group). Liver gene expression of hepcidin (Hamp) and gluconeogenic enzymes (Ppargc1a, Creb3l3, Pck1, Pygl) were determined by qRT-PCR. Effects of genotype, exercise and their interaction were assessed by two-way ANOVAs with Tukey's post-hoc tests, and Pearson correlations were used to assess the relationships between Hamp and study outcomes. Liver Hamp increased 1- and 4-fold at 3 and 6 h post-exercise, compared to rest (P-adjusted < 0⋅009 for all), and was 50% greater in REDD1 knockout compared to wild-type mice (P = 0⋅0015). Liver Ppargc1a, Creb3l3 and Pck1 increased with treadmill running (P < 0⋅0001 for all), and liver Ppargc1a, Pck1 and Pygl were greater with REDD1 deletion (P < 0⋅02 for all). Liver Hamp was positively correlated with liver Creb3l3 (R = 0⋅62, P < 0⋅0001) and Pck1 (R = 0⋅44, P = 0⋅0014). In conclusion, REDD1 deletion and prolonged treadmill running increased liver Hamp and gluconeogenic regulators of Hamp, suggesting gluconeogenic signalling of hepcidin with prolonged exercise.
Potential seed dispersal agents of Monoon liukiuense on Iriomote Island, Japan
Authors: Furumoto Ryo 
Published: April 2023

Abstract
Monoon liukiuense (Annonaceae) is an endangered tree species distributed in Iriomote Island and Hateruma Island in the Ryukyu (Nansei) Islands, Japan, and in Orchid Island (Lanyu) in Taiwan. While its habitat is confined to small areas surrounded by human-altered landscapes, the matured trees bear abundant fruits, and many offspring grow under the mother trees. M. liukiuense is hypothesised to have lost effective seed dispersers. To test this hypothesis, fate of its seeds and the behaviour of frugivores were observed using time-lapse photography during three fruiting seasons from June 2015 to August 2016 in Iriomote Island, Japan. Although several animal taxa were observed to consume the fruit pulp, only two volant animals, namely the Yaeyama flying fox and large-billed crow, were proposed as seed dispersal agents for M. liukiuense. The present study shows that an average of 82% of the fruits in the canopies fell directly beneath the fruiting trees and an average of 90% of the seeds on the forest floor remained in their original positions. These results suggest that M. liukiuense has lost most of its seed dispersal agents and the chance to expand its distribution.
Welfare, Abortion, and Organ Donation: A Reply to the Restrictivist
Authors: Carroll Emily , Crutchfield Parker 
Published: April 2023

We argued in a recent issue of this journal that if abortion is restricted,1 then there are parallel obligations for parents to donate body parts to their children. The strength of this obligation to donate is proportional to the strength of the abortion restrictions. If abortion is never permissible, then a parent must always donate any organ if they are a match. If abortion is sometimes permissible and sometimes not, then organ donation is sometimes obligatory and sometimes not. Our argument was based on the following ideas: (a) that a fetus has full moral status, (b) that parents have special obligations to their offspring, fetus or not, and (c) that this special obligation is to protect them. The result is the conclusion that abortion restrictivists cannot also consistently deny that organ donation should be compulsory.
Aripiprazole: Examining the Clinical Implications of D2 Affinity
Authors: Anam Adiba , Lynch Sean , Mosharraf Nafiz , Soukas Chloe , Gekhman Dmitriy 
Published: April 2023

AbstractBackgroundAripiprazole has high binding affinity for the dopamine D2 receptor, which is thought to be responsible for the antipsychotic effect, though aripiprazole is not the most potent of the second-generation antipsychotics. Theoretically, aripiprazole could displace or outcompete more potent antipsychotics, prompting decreased antipsychotic effect. We describe a case of aripiprazole potentially worsening psychiatric symptoms by blocking paliperidone.CaseMs. A is a 43-year-old woman with schizophrenia, multiple inpatient hospitalizations, and a history of court-ordered treatment. She historically has had good response to oral and long-acting formulations of risperidone and paliperidone. Ms. A requested a medication change and was transitioned to aripiprazole lauroxil injection with plan for bimonthly administration. Approximately 1 month after receiving her aripiprazole lauroxil injection, Ms. A presented to our CPEP due to symptoms of psychosis and was admitted to our inpatient unit. She was restarted on oral paliperidone, titrated up to her previously effective dose, and was transitioned to paliperidone palmitate LAI. In contrast to prior admissions, she did not respond well to paliperidone and displayed continued and worsened psychosis.DiscussionPrior studies have examined how adding aripiprazole to another, more potent D2 antagonist can cause a relapse in psychotic symptoms; however, few studies have investigated the inverse relationship or mechanism. Those that have proposed mechanisms typically refer to aripiprazole’s partial agonist activity as the causative factor, rather than an impediment to antipsychotic binding which we have described. Prescribers should be aware of this potential interaction and carefully consider initiating long-acting injectable forms of aripiprazole to avoid this phenomenon.FundingNo Funding
Conducting Women’s Groups in the Inpatient Unit: Empowering a High-Risk Population by Preventing Unplanned Pregnancies
Authors: Puri Avanti , Iruvanti Sirisha , Abrudan Patricia , Wargo Samantha , Huebschmann Anna 
Published: April 2023

AbstractIntroductionWomen with mental illness are 5x more likely to experience an unplanned pregnancy due to lower rates of effective contraception use; they also experience higher rates of adverse pregnancy outcomes. Education about women’s reproductive health and family planning are not routinely offered in inpatient mental health and addiction treatment settings.MethodsWeekly women’s groups on the inpatient psychiatry unit were led by psychiatry residents who were trained and provided a script. Groups focused on structured contraception education followed by an open-discussion format.Data collected included the percentage of women with history of contraception use, child protective service involvement, unplanned pregnancies, abortions, and percentage of women who found the group helpful. Special care was taken to discuss contraception as a tool for empowering women to make their own decisions about their contraceptive needs.ResultsThirteen sessions were conducted, and attendance among women on the inpatient unit was 42%. Out of the 32 patients who participated, 100% found the group beneficial and responded they would share information they learned with women outside the group. 26.4% self-identified as using contraception, 50% had unplanned pregnancy, 23.6% have had an abortion, and 26.4% have had child protective services involvement.Dissemination of contraceptive information in these women’s groups effectively led women to consider options that were available to them and seek contraceptive methods that were appropriate to their situation. Women reported they gained a better understanding of the medical, emotional, and financial implications of unplanned pregnancies. The groups were conducted in an open-discussion format that allowed women to participate in shared experiences; in many cases, the discussions were therapeutic. Feedback from patients and unit staff was positive. Many patients requested further groups to discuss issues women face, such as domestic violence and experiences as a mother.ConclusionsConducting women’s groups on the inpatient unit is critical in view of the poor access to healthcare that vulnerable women who seek inpatient psychiatric care experience. The groups on the inpatient unit are unique because it is often the only time these women have an opportunity for crucial, gender-specific preventative healthcare. These groups should further lead to appropriate referral and follow-up with primary care or women’s clinic providers.Ongoing efforts will be put forth to increase group attendance, to incorporate participation from unit staff, and to build this group into a resident curriculum for group therapy.FundingNo Funding
Reliability of the Clinician’s Tardive Inventory (CTI)
Authors: Trosch Richard M. , Comella Cynthia L. , Caroff Stanley N. , Ondo William G. , Shillington Alicia C. , LaChappelle Brandon J. , Hauser Robert A. , Correll Christof U. , Friedman Joseph H. 
Published: April 2023

AbstractObjectivesCurrently utilized clinician-rated symptom scales for tardive dyskinesia (TD) have not kept up with the expanding spectrum of TD phenomenology. The objective of this study was to develop and test the reliability of a new instrument, the CTI.MethodsA movement disorder neurologist devised the outline of the scale. A steering committee (four neurologists and two psychiatrists) provided revisions until consensus was reached. The resulting instrument assesses frequency of abnormal movements of the eye/eyelid/face, tongue/mouth, jaw, limb/trunk, complex movements (e.g., handwringing, self-caressing), and vocalizations. The CTI rates symptoms from 0–3 with 0 = absent, 1 = infrequent/intermittent or only present with activating maneuvers, 2 = frequent intermittent, brief periods without movements, 3 = constant or nearly constant. Functional impairments including activities of daily living (ADL), social impairment, symptom bother, and harm are rated 0–3 with 0 = patient is unaware or unaffected, 1 = symptoms mildly impact patient, 2 = symptoms moderately impact patient, 3 = symptoms severely impact patient. Following institutional review board approval, the CTI underwent inter-rater and test-retest reliability testing. Videos of patient TD examinations were obtained and reviewed by two movement disorder specialists to confirm the diagnosis of TD by consensus and the adequacy to demonstrate a TD-consistent movement. Vignettes were created to include patients’ symptom descriptions and functional, social, or occupational impairments/limitations. Four clinicians rated each video/vignette. Selected videos/vignettes were also subject to an intra-rater retest. Interrater agreement was analyzed via 2-way random-effects interclass correlation (ICC) and test-retest agreement assessment utilizing Kendall’s tau-b.Results45 video/vignettes were assessed for interrater reliability, and 16 for test-retest reliability. ICCs for movement frequency were as follows: abnormal eye movement .89; abnormal tongue/mouth movement .91; abnormal jaw movement .89; abnormal limb movement .76; complex movement .87; abnormal vocalization .77; and functional impairments including harm .82; social embarrassment .88; ADLs .83; and symptom bother .92. Retests were conducted on mean (SD) 15 (3) days later with scores ranging from .66–.87.ConclusionsThe CTI is a new instrument with good reliability in assessing TD symptoms and functional impacts. Future validation study is warranted.FundingNeurocrine Biosciences