bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ethics of consent during labour and birth: episiotomies
Authors: van der Pijl Marit , Verhoeven Corine , Hollander Martine , de Jonge Ank , Kingma Elselijn 
Published: January 2023

Unconsented episiotomies and other procedures during labour are commonly reported by women in several countries, and often highlighted in birth activism. Yet, forced caesarean sections aside, the ethics of consent during labour has received little attention. Focusing on episiotomies, this paper addresses whether and how consent in labour should be obtained. We briefly review the rationale for informed consent, distinguishing its intrinsic and instrumental relevance for respecting autonomy. We also emphasise two non-explicit ways of giving consent: implied and opt-out consent. We then discuss challenges and opportunities for obtaining consent in labour and birth, given its unique position in medicine.We argue that consent for procedures in labour is always necessary, but this consent does not always have to be fully informed or explicit. We recommend an individualised approach where the antenatal period is used to exchange information and explore values and preferences with respect to the relevant procedures. Explicit consent should always be sought at the point of intervening, unless women antenatally insist otherwise. We caution against implied consent. However, if a woman does not give a conclusive response during labour and the stakes are high, care providers can move to clearly communicated opt-out consent. Our discussion is focused on episiotomies, but also provides a useful starting point for addressing the ethics of consent for other procedures during labour, as well as general time-critical medical procedures.
From the slow to the rapid neutron capture process
Authors: Thielemann Friedrich-Karl 
Published: January 2023

AbstractThis contribution starts with memories about Franz Käppeler, as a human being and a scientist, his impact on neutron capture nucleosynthesis via experiments and astrophysical studies, before extending from his focus (the s-process) to the r-process, discussing its mechanism, related astrophysical sites and examining in a concluding section its role during galactic evolution.
Multi-TeV photons from GRB 221009A: uncertainty of optical depth considered
Authors: Zhao Zhi-Chao , Zhou Yong , Wang Sai 
Published: January 2023

AbstractIt is reported that the Large High Altitude Air Shower Observatory (LHAASO) observed thousands of very-high-energy photons up to $$\sim $$
∼
18 TeV from GRB 221009A. We study the survival rate of these photons via considering the fact that they are absorbed by the extragalactic background light. By performing a set of $$10^6$$

10
6

Monte-Carlo simulations, we explore the parameter space allowed by current observations and estimate the probability of predicting that LHAASO detects at least one photon of 18 TeV from GRB 221009A. We find that the standard physics is compatible with the observations of 18 TeV photons within $$3.5\sigma $$

3.5
σ

confidence interval. Our research method can be straightforwardly generalized to study more data sets of LHAASO and other experiments in the future.
CEACAM1 Marks Highly Suppressive Intratumoral Regulatory T Cells for Targeted Depletion Therapy
Authors: Jeon Seung Hyuck , Kang Minyong , Jeon Minwoo , Chung Youseung , Kim A Reum , Lee Yong Joon , Kim Eui-Soon , Nam Heejin , Park Junsik , Lee Jung-Yun , Shin Eui-Cheol , Seo Seong Il , Park Su-Hyung 
Published: January 2023

Abstract

Purpose:
Regulatory T cells (Tregs) exert immunosuppressive functions and hamper antitumor immune responses in the tumor microenvironment. Understanding the heterogeneity of intratumoral Tregs, and how it changes with tumor progression, will provide clues regarding novel target molecules of Treg-directed therapies.

Experimental Design:
From 42 patients with renal cell carcinoma and 5 patients with ovarian cancer, immune cells from tumor and peripheral blood were isolated. We performed multicolor flow cytometry and RNA-sequencing to characterize the phenotypes and heterogeneity of intratumoral Tregs. In vitro functional assays were performed to evaluate suppressive capacity of Tregs and effect of carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1)-mediated depletion. The CT26 tumor model was used to evaluate the association between intratumoral Tregs and tumor growth, and examine the in vivo role of CEACAM1+ intratumoral Tregs on antitumor immunity.

Results:
We found that CEACAM1 was selectively expressed on intratumoral Tregs, whereas its expression on peripheral Tregs or other immune cells was low. The CEACAM1+ intratumoral Tregs accumulated with tumor progression, whereas the CEACAM1− subset did not. Notably, we found that CEACAM1 marked intratumoral Tregs that exhibited highly suppressive and activated phenotypes with substantial clonal expansion. Depletion of CEACAM1-expressing cells from tumor-infiltrating leukocytes led to increased effector functions of tumor-infiltrating T cells. Moreover, CEACAM1+ cell depletion further enhanced anti-PD-1–mediated reinvigoration of exhausted CD8+ T cells.

Conclusions:
CEACAM1 marks highly suppressive subset of intratumoral Tregs, and can be a target for selective depletion of intratumoral Tregs. These results may inform future studies on CEACAM1-mediated depletion in patients with cancer.
The “Innards” in the Psalms and Job as Metaphors for Illness
Authors: Southwood Katherine 
Published: January 2023

Abstract
This article explores body and illness metaphors in the Psalms and Job. Specifically, it focuses on the various terms pertaining to the “innards” or “internal organs” of the human body. Although myriad terms for internal organs exist, the terms קֶרֶב and מֵעֶה are the particular focus of this article. Interestingly, a link between discourse and digestion emerges in the metaphors from both Job and the Psalms. However, in Job a language for pain emerges which is disturbing and anthropomorphic, regularly depicting an attacking deity. In contrast, in the examples from the Psalms, tend to make a clearer distinction between the righteous and the wicked. In both cases, however, the body and metaphors connected to it are tightly bound up with what is social. The body is portrayed as an ever-interpreted entity and the actions and reactions of the community are all-important.
Quantifying the Relationship between Embedded Rotation and Extreme Rainfall Rates in Observations of Tropical Storm Imelda (2019)
Authors: Mazurek Alexandra C. , Schumacher Russ S. 
Published: January 2023

Abstract
Previous work on continental convective systems has indicated that there is a positive relationship between short-term rainfall rates and storm-scale to mesoscale rotation. However, little has been done to explore this relationship in dense observing networks or in landfalling tropical cyclone (LTC) environments. In an effort to quantify the relationship between rainfall rates and embedded rotation of this scale, we use several sets of observations that were collected during Tropical Storm Imelda (2019). First, a meteorological overview of the event is presented, and the ingredients that led to its flash flood–producing rainfall are discussed. Then, two analyses that investigate the relationship between rainfall rates and storm-scale to mesoscale rotation in the LTC remnants are examined. The first method relies on products from the Multi-Radar Multi-Sensor system, where two spatial averaging approaches are applied to the 0–2-km accumulated rotation track and gauge bias-corrected quantitative precipitation estimate products over hourly time periods. Using these fields as proxies for rotation and rain rates, the results show a positive spatiotemporal relationship between the two products. The second method time matches subjectively identified radar-based rotation and 5-min surface rain gauge observations. There, we show that nearly twice the amount of rain was recorded by the gauges when storm-scale to mesoscale rotation was present nearby, and the differences in 5-min rainfall observations between when rotation was present versus not was statistically significant. Together, these results indicate that more rain tended to fall in locations where there was rotation embedded in the system.

Significance Statement
Tornadoes and flash floods frequently occur in unison over the same locations, which can complicate forecasting, warning, and communication efforts within the meteorology community. Previous work has furthered the understanding of the interconnectedness of these hazards by suggesting a relationship between two of their predecessors: storm rotation and rainfall rates. We build on this research by quantifying the relationship of these two processes using observations from Tropical Storm Imelda: a system that brought devastating flooding to southeast Texas in September 2019. Our results show across multiple observational datasets that more rain tended to fall in locations where there was rotation embedded in the tropical storm remnants.
Thermodynamic Contribution to Vortex Alignment and Rapid Intensification of Hurricane Sally (2020)
Authors: Stone Željka , Alvey G. R. , Dunion J. P. , Fischer M. S. , Raymond D. J. , Rogers R. F. , Sentić S. , Zawislak J. 
Published: January 2023

Abstract
As a part of the Tropical Cyclone Rapid Intensification Project (TCRI), observations were made of the rapid intensification of Hurricane Sally (2020) as it passed over the Gulf of Mexico. High-altitude dropsondes and radar observations from NOAA’s Gulfstream IV, radar observations from WP-3D aircraft, the WSR-88D ground radar network, satellite images, and satellite-detected lightning strikes are used to apply recently developed theoretical knowledge about tropical cyclone intensification. As observed in many other tropical cyclones, strong, bottom-heavy vertical mass flux profiles are correlated with low (but positive) values of low- to midlevel moist convective instability along with high column relative humidity. Such mass flux profiles produce rapid spinup at low levels and the environmental conditions giving rise to them are associated with an intense midlevel vortex. This low-level spinup underneath the midlevel vortex results in the vertical alignment of the vortex column, which is a key step in the rapid intensification process. In the case of Sally, the spinup of the low-level vortex resulted from vorticity stretching, while the spinup of the midlevel vortex at 6 km resulted from vorticity tilting produced by the interaction of convective ascent with moderate vertical shear.

Significance Statement
The purpose of this study is to investigate the rapid intensification of Hurricane Sally as it was approaching the Florida Panhandle. We do that by analyzing an unprecedented dataset from the NOAA WP-3D and Gulfstream-IV aircraft, together with ground-based radar and satellite data. We find that both the dynamics (vorticity structure and evolution) and thermodynamics (instability index, saturation fraction, heating/mass flux profiles) need to be considered in diagnosing intensification processes. Further field projects with continuous high-altitude dropsondes and research are needed to see if these are applicable to other reformation events as well as genesis.
Reconsideration of Return-to-Sport Decision-Making After Pediatric ACL Injury: A Scoping Review
Authors: Pauw Anne Hendrika Johanna , Buck Tristan Marcel Frank , Gokeler Alli , Tak Igor Joeri Ramon 
Published: January 2023

Context: Up to 90% of pediatric athletes return to sport (RTS) after anterior cruciate ligament reconstruction (ACL-R); however, <50% RTS at the same level and second ACL injury rates are up to 32%. Objectives: (1) Determine which physical and patient-reported outcome measures guide clinical decision-making on RTS in pediatric athletes after ACL-R and (2) present a framework with insights from cognitive and neurophysiological domains to enhance rehabilitation outcomes. Data Sources: PubMed, CINAHL, Embrase, and Cochrane library databases and gray literature. Study Selection: Data on pediatric (<18 years) ACL-R patients, RTS, tests, and decision-making were reported in 1214 studies. Two authors independently reviewed titles and abstract, excluding 962 studies. Gray literature and cross-reference checking resulted in 7 extra studies for full-text screening of 259 studies. Final data extraction was from 63 eligible studies. Study Design: Scoping review. Level of Evidence: Level 4. Data Extraction: Details on study population, aims, methodology, intervention, outcome measures, and important results were collected in a data chart. Results: Studies included 4456 patients (mean age, 14 years). Quadriceps and hamstring strength (n = 25), knee ligament arthrometer (n = 24), and hop tests (n = 22) were the most-reported physical outcome measures guiding RTS in <30% of studies with cutoff scores of limb symmetry index (LSI) ≥85% or arthrometer difference <3 mm. There were 19 different patient-reported outcome measures, most often reporting the International Knee Documentation Committee (IKDC) (n = 24), Lysholm (n = 23), and Tegner (n = 15) scales. Only for the IKDC was a cutoff value of 85% reported. Conclusion: RTS clearance in pediatric ACL-R patients is not based on clear criteria. If RTS tests were performed, outcomes did not influence time of RTS. Postoperative LSI thresholds likely overestimate knee function since biomechanics are impaired despite achieving RTS criteria. RTS should be considered a continuum, and biomechanical parameters and contextual rehab should be pursued with attention to the individual, task, and environment. There is a need for psychological monitoring of the ACL-R pediatric population.
Clinical and epidemiological features of paroxysmal cold hemoglobinuria: a systematic review
Authors: Jacobs Jeremy W. , Figueroa Villalba Cristina A. , Booth Garrett S. , Woo Jennifer S. , Stephens Laura D. , Adkins Brian D. 
Published: January 2023

Abstract
Paroxysmal cold hemoglobinuria (PCH) is a rare autoimmune hemolytic anemia often overlooked as a potential etiology of hemolysis and is challenging to diagnose because of the complicated testing methods required. We performed a systematic review of all reported cases to better assess the clinical, immunohematologic, and therapeutic characteristics of PCH. We systematically analyzed PubMed, Medline, and EMBASE to identify all cases of PCH confirmed by Donath-Landsteiner (DL) testing. Three authors independently screened articles for inclusion, and systematically extracted epidemiologic, clinical, laboratory, treatment, and outcomes data. Discrepancies were adjudicated by a fourth author. We identified 230 cases, with median presentation hemoglobin of 6.5 g/dL and nadir of 5.5 g/dL. The most common direct antiglobulin test (DAT) result was the presence of complement and absence of immunoglobulin G (IgG) bound to red blood cells, although other findings were observed in one-third of cases. DL antibody class and specificity were reported for 71 patients, of which 83.1% were IgG anti-P. The use of corticosteroids is common, although we found no significant difference in the length of hospitalization for patients with and without steroid therapy. Recent reports have highlighted the use of complement inhibitors. Among patients with follow-up, 99% (213 of 216) were alive at the time of reporting. To our knowledge, this represents the largest compilation of PCH cases to date. We discovered that contemporary PCH most commonly occurs in children with a preceding viral infection, corticosteroid use is frequent (but potentially ineffective), and DAT results are more disparate than traditionally reported.
Human liver microbiota modeling strategy at the early onset of fibrosis
Authors: Champion Camille , Neagoe Radu M. , Effernberger Maria , Sala Daniela T. , Servant Florence , Christensen Jeffrey E. , Arnoriaga-Rodriguez Maria , Amar Jacques , Lelouvier Benjamin , Loubieres Pascale , Azalbert Vincent , Minty Matthieu , Thomas Charlotte , Blasco-Baque Vincent , Gamboa Fabrice , Tilg Herbert , Cardellini Marina , Federici Massimo , Fernández-Real Jose-Manuel , Loubes Jean Michel , Burcelin Rémy 
Published: January 2023

Abstract
Background
Gut microbiota is involved in the development of liver diseases such as fibrosis. We and others identified that selected sets of gut bacterial DNA and bacteria translocate to tissues, notably the liver, to establish a non-infectious tissue microbiota composed of microbial DNA and a low frequency live bacteria. However, the precise set of bacterial DNA, and thereby the corresponding taxa associated with the early stages of fibrosis need to be identified. Furthermore, to overcome the impact of different group size and patient origins we adapted innovative statistical approaches. Liver samples with low liver fibrosis scores (F0, F1, F2), to study the early stages of the disease, were collected from Romania(n = 36), Austria(n = 10), Italy(n = 19), and Spain(n = 17). The 16S rRNA gene was sequenced. We considered the frequency, sparsity, unbalanced sample size between cohorts to identify taxonomic profiles and statistical differences.

Results
Multivariate analyses, including adapted spectral clustering with L1-penalty fair-discriminant strategies, and predicted metagenomics were used to identify that 50% of liver taxa associated with the early stage fibrosis were Enterobacteriaceae, Pseudomonadaceae, Xanthobacteriaceae and Burkholderiaceae. The Flavobacteriaceae and Xanthobacteriaceae discriminated between F0 and F1. Predicted metagenomics analysis identified that the preQ0 biosynthesis and the potential pathways involving glucoryranose and glycogen degradation were negatively associated with liver fibrosis F1-F2 vs F0.

Conclusions
Without demonstrating causality, our results suggest first a role of bacterial translocation to the liver in the progression of fibrosis, notably at the earliest stages. Second, our statistical approach can identify microbial signatures and overcome issues regarding sample size differences, the impact of environment, and sets of analyses.

Trial registration
TirguMECCH ROLIVER Prospective Cohort for the Identification of Liver Microbiota, registration 4065/2014. Registered 01 01 2014.
Superior mesenteric artery embolism after radiofrequency ablation in regularly anticoagulated patients with paroxysmal atrial fibrillation: a case report
Authors: Jing Yongle , Xu Jianqiang , Chen Bingwei , Xia Dasheng , Xia Dachuan , Tian Yunpeng , Xia Wei , Lu Chengzhi , Wu Yuli 
Published: January 2023

Abstract
Background
Superior mesenteric artery embolism (SMAE) is a rare cause of acute abdomen, and the fatality rate is extremely high if it is not diagnosed and treated in time. Due to the lack of knowledge and experience of nonspecialist physicians, it is easy to misdiagnose. Radiofrequency ablation (RFA) has become the first-line treatment strategy for atrial fibrillation (AF). Thromboembolic events are some of the major complications after RFA, whereas SMAE is rarely reported.

Case presentation
A 70 year-old woman with paroxysmal AF who regularly took anticoagulant drugs for 3 months experienced abdominal pain after RFA. At the outset, she was misdiagnosed as mechanical intestinal obstruction. When the patient presented with blood in the stool, abdominal enhancement computed tomography was conducted and showed a small bowel perforation. Immediate laparotomy was performed, and the final diagnosis was SMAE.

Conclusion
It is suggested that for unexplained abdominal pain after RFA of AF, the possibility of SMAE should be considered, and a targeted examination should be carried out in time to confirm the diagnosis and give appropriate treatment.
No advantage of single day 6 good-quality blastocyst transfer versus single day 5 poor-quality blastocyst transfer in frozen-thawed cycles stratified by age: a retrospective study
Authors: He Yuxia , Tang Yan , Liu Haiying , Liu Jianqiao , Mao Yuling 
Published: January 2023

Abstract
Background
Blastocyst developmental speed, morphological grading and patient age are associated with pregnancy outcomes of frozen-thawed cycles. This study aimed to compare the clinical and neonatal outcomes between poor-quality D5 blastocysts and good-quality D6 blastocysts stratified by patient age.

Methods
A total of 1,623 cycles were divided into two groups: group A (n = 723) received one D5 poor-quality blastocyst; group B (n = 900) received one D6 good-quality blastocyst. Pregnancy and neonatal outcomes were compared among the four groups stratified by 35 years of age.

Results
When patients were in the same age group, there was no significant difference in terms of age, body mass index, infertility duration, infertility type, fertilization method, proportion of endometrial preparation protocols, and endometrial thickness between D5 poor-quality and D6 high-quality blastocysts groups. Live birth rate of D5 poor-quality blastocysts was higher than that of D6 high-quality blastocysts for patients aged < 35 years (35.48% vs. 31.13%, p > 0.05), but there was no statistical difference. The same trend was showed for patients aged ≥ 35 years (29.09% vs. 21.28%, p > 0.05). Moreover, when patients were in the same age category, there was no significant difference in terms of gestational age, birth weight, birth height, and rates of preterm birth, low birth weight, and very low birth weight between groups A and B.

Conclusions
The preferential selection of poor-quality D5 blastocysts for transfer compared to high-quality D6 blastocysts is recommended, especially for advanced age patients. Single good-quality D6 blastocyst transfer can be considered for the acceptable live birth rate.
Combined anti-C1-INH and radiotherapy against glioblastoma
Authors: Liljedahl Emma , Konradsson Elise , Gustafsson Emma , Jonsson Karolina Förnvik , Olofsson Jill K. , Osther Kurt , Ceberg Crister , Redebrandt Henrietta Nittby 
Published: January 2023

Abstract
Background
A more effective immune response against glioblastoma is needed in order to achieve better tumor control. Radiotherapy can induce anti-tumor mediated immune reactions, in addition to its dose response effects. The complement system can function as a bridge between innate and adaptive immune responses. Combining radiotherapy and complement activating therapy is theoretically interesting.

Methods
Radiotherapy at 8 Gy × 2 was combined with treatment against C1-inhibitor (C1-INH), a potent inhibitor of activation of the classical pathway of the complement system. Anti-C1-INH was delivered as intratumoral injections. Fully immunocompetent Fischer 344 rats with NS1 glioblastoma tumors were treated. Survival was monitored as primary outcome. Models with either intracranial or subcutaneous tumors were evaluated separately.

Results
In the intracranial setting, irradiation could prolong survival, but there was no additional survival gain as a result of anti-C1-INH treatment. In animals with subcutaneous tumors, combined radio-immunotherapy with anti-C1-INH and irradiation at 8 Gy × 2 significantly prolonged survival compared to control animals, whereas irradiation or anti-C1-INH treatment as single therapies did not lead to significantly increased survival compared to control animals.

Conclusions
Anti-C1-INH treatment could improve the efficacy of irradiation delivered at sub-therapeutic doses and delay tumor growth in the subcutaneous tumor microenvironment. In the intracranial setting, the doses of anti-C1-INH were not enough to achieve any survival effect in the present setting.