bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ancient Greek Dining Spaces: The Rooms of the South Stoa at Corinth
Authors: Scahill David 
Published: April 2023

Abstract
This paper explores the architectural manifestations for ritual and public dining spaces in the ancient Greek world as defined by architectural characteristics or other material remains. Hestiatoria have traditionally been defined as “dining spaces” on the basis of loose architectural distinctions, such as rooms set aside in sanctuaries, sometimes with off-center doorways, indications of klinai or other small finds that suggest dining. Rooms in stoas sometimes served for dining purposes, as is well attested, but the form of the complexes differs substantially. Can there be a more precise typology made of these buildings and the indicators which might suggest different practices? Are there specific differences architecturally between ritual dining and public dining? These and other considerations are addressed in conjunction with literary testimonia for dining practices in an attempt to bring into focus the varied architectural record.
From Exclusive Dream Oracles to Ubiquitous Incubation Dreams: A Change in the Perception of a Divine Healer?
Authors: von Ehrenheim Hedvig 
Published: April 2023

Abstract
This paper argues that the cult of Asklepios developed and spread fast due to a shift in mentality in Classical Greece. This change concerned both who might communicate directly with the gods in dreams, as well as the development of a new way of envisaging healing. It is argued that the notion that anybody could receive a godsent dream, as seen in numerous incubation sanctuaries, reflects a change in mentality in Classical times. It is further argued that religious healing in the cult of Asklepios was influenced by the development of Greek medicine in Archaic times, and the ease and low expense of consulting a Hippokratic doctor in Classical times.
Dedicatory Paintings in Greek Religion: An Initial Assessment
Authors: Renberg Gil H. 
Published: April 2023

Abstract
This contribution presents the first survey of the full range of sources for the dedication of paintings to the gods of the Greek-speaking world, including Egypt. This phenomenon has been largely overlooked due to the rarity of such dedications, in contrast to the countless dedicatory objects fashioned from stone and other durable materials, which have survived in relative abundance. Although some types of dedicatory painting, particularly the well-known Archaic and Classical terracotta pinakes from Attika and the painted wooden panels from Pitsa, have been studied by numerous scholars, other examples have been neglected, along with many written sources. Seeking to fill this gap in the scholarship, this article collects the full range of sources demonstrating the importance of paintings as a type of dedication – not only the paintings that still survive on terracotta, stone, and stucco, but also a varied and intriguing body of literary and epigraphical testimonia. The result is a study that for the first time provides scholars of Greek religion and Greek art a detailed overview of this aspect of Greek cult, and delves into various issues – methodological and otherwise – crucial to understanding its nature.
To Remain or to Terminate? The Quest for Strategic Autonomy: An Autonomy Cost Model of Alliance Duration
Authors: Lee Jinwon 
Published: April 2023

Abstract
Alliances are agreements among independent states to cooperate militarily in the face of potential or realized military conflict. However, not all alliances endure for decades. Existing empirical evidence suggests that there is a variance in the lifespan of alliances. I argue that alliances are more likely to be dissolved when their treaty obligations undermine autonomy in a state’s core security or military strategy. In this vein, I also insist that ‘strategic autonomy’ is a key factor in the termination of alliance and alliance duration. Alliances with strong ‘strategic autonomy constraints’ would not last longer than others. I use the ATOP data and principal components analysis (PCA) technique to test this argument to identify a strategic autonomy variable. The extracted principal components (PCs) are used as explanatory variables in regression. This paper finds that alliances with strategic autonomy constraints do not last longer than alliances that are not constrained, and the empirical results are consistent with the hypotheses.
An Analysis of ASEAN’s Cyclone Nargis 2008 Disaster Diplomacy
Authors: Papp Bendegúz 
Published: April 2023

Abstract
Cyclone Nargis in 2008 is remembered as one of the deadliest disasters of modern Southeast Asia. Myanmar suffered the greatest losses of the states in the region, with more than a hundred thousand deaths and millions affected. The present research examines the events of the storm in a disaster diplomacy context. The methodological framework of the study is the Complex Adaptive System, which is applied through four properties and three mechanisms. According to the results, Cyclone Nargis hit the region in a cold international environment, and its treatment ended with a (to some extent) successful regional diplomatic outcome after easing the initial abstention. Among the variables of the CAS method, nonlinearity and aggregation, as well as internal model and building blocks, determined regional cooperation. The present case study shows that an extremely severe natural disaster is capable of promoting regional cooperation despite the actual cold political environment.
Regulatory Cooperation for Vaccines: The Asia-Pacific and Beyond
Authors: Lacey Simon , Mitchell Andrew D 
Published: April 2023

Abstract
The COVID-19 pandemic galvanized national regulatory authorities (NRAs) to adopt innovative and cooperative vaccine approval approaches. Against a backdrop of deaths, economic paralysis, and political instability, it became clear that legacy approaches to vaccine approvals would no longer suffice. Regulatory cooperation between NRAs has developed since the 1960s in Europe and later in other regions. But the crisis wrought by COVID-19 has instilled a new sense of the value of networking, work-sharing, reliance, and recognition among NRAs in all countries and regions. Regional and multilateral collaboration — particularly in the Asia-Pacific — have also enabled shared knowledge and resources while contributing to some degree of harmonization in rules and procedures. Indeed, this will likely pave the way for dealing with future global health crises. Yet, amidst the detritus, there is much to learn.
Laparoscopic Gastrectomy for Advanced Gastric Cancer
Authors: Yamamoto Kazuyoshi , Omori Takeshi , Kurokawa Yukinori , Takeno Atsushi , Akamaru Yusuke , Demura Koichi , Okada Kazuyuki , Kishi Kentaro , Saito Takuro , Takahashi Tsuyoshi , Eguchi Hidetoshi , Doki Yuichiro 
Published: April 2023

Background Application of laparoscopic gastrectomy (LG) to advanced gastric cancer is still controversial due to lack of sufficient surgical and oncological outcomes. The purpose of this study was to elucidate the feasibility of LG for advanced gastric cancer by multicenter prospective cohort study. Methods A total of 98 patients with clinical stage II or III gastric cancer from 8 institutes were analyzed in this study. The primary endpoint was incidence of severe postoperative complications of Clavien-Dindo classification grade Ⅲa or higher. Results Sixty-six patients underwent laparoscopic distal gastrectomy (LDG), 10 patients laparoscopic proximal gastrectomy (LPG), 21 patients laparoscopic total gastrectomy (LTG), and 1 patient received gastro-jejunostomy. Seven patients had positive lavage cytology (CY1) and R0 rate was 90.8%. Three patients (3.1%) required conversion to open surgery. The incidence of overall postoperative complications and severe postoperative complications were 17.3% and 9.2%, respectively, those were comparable to the data of open surgery for advanced gastric cancer previously published. By surgical procedure, the incidence of severe postoperative complications of LDG, LPG, and LTG were 4.6, 0, and 28.6% and the rate of severe anastomotic leakage of LDG, LPG, and LTG were 0, 0, and 9.5%, respectively. Total gastrectomy was an only independent risk factor of severe postoperative complications in LG for advanced gastric cancer (odds ratio 8.75; 95% confidence interval 1.70-56.69, P = .0092). Discussion The incidence of severe postoperative complications after LG performed by qualified surgeons was acceptable even in cases of advanced gastric cancer; however, careful attention is required to adopt LTG. (UMIN000025733).
Pyloric Duplication Cyst in Newborn Male
Authors: Morgan Alexandra D. , Ma Brenda L. , Parrish Dan W. 
Published: April 2023

An enteric duplication cyst (EDC) is a rare congenital anomaly. Although EDCs can occur at any point throughout the gastrointestinal tract, they are most commonly reported in the ileum and only around 5-7% are of gastroduodenal origin. We report a case of a pyloric duplication cyst in a 3 hour old male with prenatal ultrasound showing a cystic mass. The patient had an abdominal ultrasound after birth that showed a mass with probable trilaminar wall. The diagnosis of pyloric duplication cyst was made in surgery and confirmed with histopathologic examination following resection. The patient is doing well with appropriate weight gain at follow-up appointments.
Axial Compressive Loading Attenuates Early Osteoarthritis by Reducing Subchondral Bone Remodeling
Authors: Wu Jianqun , Pan Yonghao , Yu Yangyi , Yang Qihao , Liu Qisong , Liu Yang , Zhong Jinhao , Fu Linhao , Cai Haotian , Liu Chao , Li Guangheng 
Published: April 2023

Background: Mechanical loading and alendronate (ALN) can be used as noninvasive physical therapy methods for osteoarthritis (OA). However, the timing and efficacy for treatments are unknown. Purpose: To determine whether the timing of mechanical loading and ALN influences the pathobiological changes of OA. Study Design: Controlled laboratory study. Methods: Mice with OA induced by anterior cruciate ligament transection were subjected to early (1-3 weeks) or late (5-7 weeks) axial compressive dynamic load or intraperitoneal injection of ALN. Changes in gait were analyzed using gait analysis system, pathobiological changes in subchondral bone, cartilage, osteophyte, and synovitis were assessed using micro–computed tomography, tartrate-resistant acid phosphatase staining, pathologic section staining, and immunohistochemistry at 1, 2, 4, and 8 weeks. Results: At 1, 2, and 4 weeks, the OA limb had lower mean footprint pressure intensity, lower bone volume per tissue volume (BV/TV) in the subchondral bone, and more osteoclasts. At 4 weeks, the early loading, ALN, and load + ALN treatments induced less cartilage destruction, with a corresponding reduction in Osteoarthritis Research Society International score and increased hyaline cartilage thickness. The treatments also resulted in fewer osteoclasts and higher BV/TV and bone mineral density of subchondral bone and suppressed inflammation and interleukin 1β– and tumor necrosis factor α-positive cells in synovium. At 8 weeks, early loading or load + ALN improved the mean footprint pressure intensity and knee flexion. At 8 weeks, early load + ALN had a synergistic effect on protecting hyaline cartilage and proteoglycans. Footprint pressure intensity and cartilage destruction were worse in late loading limbs, and no differences in BV/TV, bone mineral density, osteophyte formation, and synovium inflammation were found between the late load, ALN, and load + ALN groups and the anterior cruciate ligament transection group. Conclusion: Dynamic axial mechanical loading or ALN in the early stages of knee trauma protected against OA by suppressing subchondral bone remodeling. However, late loading promoted cartilage degeneration in advanced OA, indicating that reduced loading should be performed in the late stages of OA to avoid the acceleration of OA. Clinical Relevance: Early low-level functional exercise or antiosteoporotic drugs could clearly slow or prevent the progression of early OA. For patients with mild to severe OA, loading reduction via brace protection or maintenance of joint stability via early ligament reconstruction surgery may ameliorate OA exacerbation.
Microaggressions: Experiences of Diverse Graduate Nursing Students in Online Education
Authors: Zajac Lynne K. , Benton-Lee Jitana 
Published: April 2023

Introduction: Racial microaggressions are offensive and intimidating actions toward people of color and occur everywhere, including academia. Select studies report 40% to 98% of students of color report experiences with microaggressions on campuses. The purpose of this study was to describe the experience of microaggressions for diverse graduate nursing students in the online educational environment and to identify faculty strategies to create an inclusive learning milieu. Method: This descriptive qualitative study employed 12 diverse graduate nursing students who participated in individual interviews about racial microaggressions. Two researchers used thematic analysis to evaluate the qualitative data. Results: Five relevant themes were (a) online classroom is a barrier for microaggressions, (b) requirement of profile pictures is a risk factor for microaggressions, (c) experiences of past microaggressions carries over to the present, (d) diverse online students are resourceful, and (e) the reality of microaggressions online. Discussion: Participants’ suggestions, literature evidence, and research findings informed decision/action modes to assist the nurse educator with culturally competent methods to improve online learning spaces and decrease microaggressions for diverse students.
Does Perioperative Use of Bisphosphonate Affect the Implant Revision Rate of Total Ankle Arthroplasty?
Authors: Lee Dong-Oh , Jeon Ye Jin , Park Gil Young , Lee Dong Yeon 
Published: April 2023

Background: It is unknown whether perioperative bisphosphonate (BP) use reduces revision rates in total ankle replacement arthroplasty (TAR) although its effect has been demonstrated to be effective in reducing revision rates in total knee or hip replacement arthroplasty. Methods: We reviewed National Health Insurance Service data based on national health insurance service claims data and health care utilization, health screening, sociodemographic variables, medication history, operation codes, and mortality data for 50 million Koreans. From 2002 to 2014, 6391 of 7300 patients who underwent TAR were BP nonusers, whereas 909 patients were BP users. The revision rate according to BP medication and comorbidities was investigated. The Kaplan-Meier estimate and extended Cox proportional hazard model were also used. Results: The revision rate of TAR was 7.9% for BP users and 9.5% for BP nonusers, which showed no significant difference ( P = .251). Implant survival over time decreased constantly. Adjusted hazard ratio for hypertension was 1.242 ( P = .017), whereas other comorbidities such as diabetes had no effect on the revision rate of TAR. Conclusion: We found that the perioperative BP use did not reduce the revision rate of TAR. Comorbidities (except hypertension) did not affect the revision rate of TAR. More research regarding various factors affecting the revision of TAR could be warranted. Level of Evidence: Level III, retrospective cohort study.
Initial Outcomes of Physician-Modified Inner Branched Endovascular Repair in High-Surgical-Risk Patients
Authors: Shibata Tsuyoshi , Iba Yutaka , Nakajima Tomohiro , Nakazawa Junji , Ohkawa Akihito , Hosaka Itaru , Arihara Ayaka , Tsushima Shingo , Ogura Keishi , Yoshikawa Kenta , Kawaharada Nobuyoshi 
Published: April 2023

Purpose: To report the initial outcomes of physician-modified inner branched endovascular repair (PMiBEVAR) for pararenal aneurysms (PRAs), thoracoabdominal aortic aneurysms (TAAAs), and aortic arch aneurysms in high-surgical-risk patients. Materials and Methods: A total of 10 patients (6 men; median age, 83.0 years) treated using PMiBEVAR were enrolled in this retrospective, single-center study. All patients were at high surgical risk because of severe comorbidities (American Society of Anesthesiologists physical status score≥3 or emergency repair). End points were defined as technical success per patient and per vessel (successful deployment), clinical success (no endoleaks postoperatively), in-hospital death, and major adverse events. Results: There were 3 PRAs, 4 TAAAs, and 3 aortic arch aneurysms with 12 renal-mesenteric arteries and 3 left subclavian arteries incorporated by inner branches. The technical success rate was 90.0% (9/10) per patient and 93.3% (14/15) per vessel. The clinical success rate was 90% (9/10). There were 2 in-hospital deaths, unrelated to aneurysms. Paraplegia and shower emboli occurred separately in 2 patients. Three patients experienced prolonged ventilation for 3 days after surgery. Aneurysm sac shrinkage occurred in 4 patients, and aneurysm size stabilized in 1 patient during follow-up, more than 6 months later. None of the patients required intervention. Conclusion: PMiBEVAR is a feasible approach for treating complex aneurysms in high-surgical-risk patients. This technology may complement the existing technology in terms of improved anatomical adaptability, no time delay and practicability in many countries. However, long-term durability remains undetermined. Further large-scale and long-term studies are needed. Clinical impact This is the first clinical study to investigate outcomes of physician-modified inner branched endovascular repair (PMiBEVAR). PMiBEVAR for treating pararenal aneurysm, thoracoabdominal aortic aneurysm, or aortic arch aneurysm is a feasible procedure. This technology is likely to complement existing technology in terms of improved anatomical adaptability (compared to off-the-shelf devices), no time delay (compared to custom-made devices), and the potential to be performed in many countries. On the other hand, surgery time varied greatly depending on the case, suggesting a learning curve and the need for technological innovation to perform more consistent surgeries.
The key mediators involved in myocardial endoplasmic reticulum stress induced by ischaemia reperfusion injury in rats
Authors: Qing Jiayue , Zhou Hongmei , Hu Li , Zhu Zhipeng 
Published: April 2023

Objective: Endoplasmic reticulum stress (ERS) occurs throughout the pathological process of myocardial ischaemia reperfusion injury (MIRI); however, the key mediators involved in the biological processes of ERS or that can influence the outcomes of ischaemia reperfusion injury (IRI) are unclear. To identify the differentially expressed genes (DEGs) encoding promising mediators in rat hearts in the context of MIRI, gene profiles were mined through transcriptome analysis. Methods: By searching the Gene Expression Omnibus (GEO) database, a suitable GEO dataset was identified in the context of MIRI with 24 h reperfusion after 45 min ischaemia in rats. DEGs were extracted and analysed with R studio, and the properties of those DEGs were elucidated by utilizing protein‒protein-interaction (PPI), Cytoscape, GO and KEGG bioinformatics techniques. The potential hub genes in the first cluster of the DEG dataset were retrieved and verified by basal experiments. Results: By searching the target dataset GSE122020, 1647 mRNAs, including 790 upregulated and 857 downregulated genes, were found in the datasets with criteria of | fold change ≥ 1.2 and p value <0.05. The upregulated and downregulated genes were primarily involved in the “positive regulation of cytokine production”, “regulation of inflammatory response” and “response to pheromone” biological processes. Most of them were mainly correlated with the MAPK, Ras and calcium signalling pathways. In particular, 15 DEGs were found to be involved in the ERS signalling pathways, including Bfar, Itpr1, Srpx, Hspa1b, Usp25, Jun, Casp12, Eif2ak2, Casp4, Trim25, Ifng, Atf3, Hspa1a, Ppp1r15a, and Creb3. Through analysis with the MCODE plugin in Cytoscape, six genes, Atf3, Ppp1r15a, Casp12, Eif2ak2, Ifng, and Hspa1a, were identified as hub genes by the K-means algorithm from Cluster 1. In the in vivo MIRI model, the six genes mentioned above exhibited significant mRNA overexpression in the left anterior descending coronary artery ligation (LAD) model in rats. Conclusions: Altogether, the present study identified six potential DEGs involved in ERS induced by MIRI, which could be therapeutic targets in dealing with IRI-related ERS.
Lessons learned from the impact of the COVID-19 pandemic in Brazil on primary-care workplace learning groups
Authors: Carvalho Enderson Rodrigues de , Sandars John , Cecilio-Fernandes Dario 
Published: April 2023

Background: The COVID-19 pandemic in Brazil had a major impact on face-to-face permanent education for health (PEH) workplace learning groups in primary care. Aims: The aim of the study was to explore how PEH groups in primary care changed during the COVID-19 pandemic. Methods: A qualitative exploratory evaluation study was conducted with six key participants, who answered semi-structured questions in on-line interviews. Results: The PEH groups rapidly and successfully implemented an online approach using social media. The role of the coordinator changed from being a facilitator to an information broker for navigating the large volume of conflicting information and misinformation. Conclusions: The findings highlight the importance of being an agile organisation, with a ‘bottom-up’ approach to innovation, and the key role of having an information broker in rapidly changing and complex environments. An appreciation of the importance of the socio-technical system for technology implementation in an organisation was also highlighted, with the use of technologies that are familiar to members of the organisation.
Nurses’ experiences of the social stigma caused by the COVID-19 pandemic: a qualitative study
Authors: Nabavian Majedeh , Rahmani Narges , Seyed Nematollah Roshan FatemehSadat , Firouzbakht Mojgan 
Published: April 2023

Background: One of the psychological issues that health personnel face when treating COVID-19 patients is the societal stigma. This issue has not been addressed due to the disease’s devastating impact on numerous sectors of society. This study aimed to evaluate nurses’ experiences of social stigma caused by the COVID-19 pandemic with a qualitative approach. Methods: Inductive qualitative content analysis was used to conduct this qualitative research. COVID ward nurses who had been subjected to social stigma were chosen as the study sample. Data were collected through semi-structured and individual interviews and were concurrently analysed using the conventional content analysis approach recommended by Graneheim and Lundman. Results: There are three categories and six sub-categories of social stigma experienced by nurses: (1) paradoxical emotions (psychological stress and positive attitude), (2) abandonment (all-round rejection and isolation) and (3) coping strategies (self-awareness over time and the influential role of the media). Conclusions: The findings of this study can help healthcare managers to improve the quality of care by enhancing understanding of the psychological needs arising from social stigma. Based on these findings, designing psychosocial interventions related to stigma can promote the mental health of this group and their families.