bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upon the Roof of the Temple: Reconstructing Cognitive Aspects of Ancient Levantine Small-Scale Altar Usage
Authors: Hutton Jeremy M. 
Published: May 2023

Abstract
Among the ritual practices denigrated through explicit or implicit criticism levied by the biblical writers is the worship of a deity or deities on the rooftops – sometimes of royal architecture, and at other times on private houses. In the present study I interpret this practice using concepts derived from the cognitive science of religion (CSR) and cognitive linguistics. I summarize previous typologies of objects employed in the sacrificial cult of the ancient Southern Levant, confirming prior arguments for understanding shaft-type limestone altars as stylized models of architectural precursors. From a cognitive perspective, these stylized architectural models prompted offrants to run a conceptual blend that replaced the modest small-scale vegetable or incense offering of the offrant’s small-scale input space with the more sumptuous small-scale offering – or even large-scale animal sacrifice – of the monumental-scale input. This cognitive explanation provides explanation for Deuteronomistic and Priestly attempts to limit the practice, and occasions insight into the temporal aspects of “sacred space.”
A Proposal for Advancing Implementation of the Responsibility to Protect
Authors: Barber Rebecca 
Published: May 2023

Abstract
This article takes as its starting point the support for the Responsibility to Protect (R2P) expressed during the General Assembly’s 2022 debate on the R2P, and the express interest of states in shifting discussions about the R2P away from debate about the principle’s normative content and status, towards implementation. It asserts that efforts to advance the implementation of R2P face three key obstacles. First, the R2P is insufficiently defined, leaving room for damaging misperceptions about the R2P to be sustained. Second, states have not been supported to translate their in-principal commitment to the R2P into national strategies or plans. Third, the R2P is not sufficiently institutionalised either within the United Nations (UN) or regional organisations. Drawing on the atrocity prevention literature as well as the policy and practice of states, this article proposes a three-part strategy for advancing implementation of the R2P, responding to these three identified challenges.
Decompositional Forms: Asiatic Disfigurement, Sensorial Excess, and Queer Inhumanisms in Candice Lin’s Natural History
Authors: Lee Michelle 
Published: May 2023

Abstract
This article analyzes Candice Lin’s 2020 solo exhibition, Natural History: A Half-Eaten Portrait, an Unrecognizable Landscape, a Still Still Life, a show that reflects the artist’s ongoing enquiry into non-Western botanical knowledge and attempts to develop nontoxic death rituals by building more-than-human intimacies. Merging the biological processes associated with decomposition and the discursive formations of race and gender, the work also interrogates the knowledge systems constructed by museums. I examine Lin’s works through the lens of queer inhumanisms to illustrate how this exhibition challenges modern curatorial practices and historical representations of the Asiatic in natural histories. I refer to this aesthetics of disfigurement as “decompositional forms.” Ultimately, I forward that this method of representation renders Asian American racial form into multisensorial registers (which literally penetrate art consumers) to recognize racial histories beyond identity and alongside the omni-presence of the more-than-human.
Convective Variabilities Leading to Different Pathways of Convective Self-Aggregation in Two Cloud-Resolving Models
Authors: Huang Jin-De , Hung Ching-Shu , Wu Chien-Ming , Miura Hiroaki 
Published: May 2023

Abstract
Convective variability is used to diagnose different pathways toward convective self-aggregation (CSA) in radiative–convective equilibrium simulations with two cloud-resolving models, SCALE and VVM. The results show that convection undergoes gradual growth in SCALE and fast transition in VVM, which is associated with different mechanisms between the two models. In SCALE, strong radiative cooling associated with a dry environment drives the circulation from the dry region, and the dry environment results from strong subsidence and insufficient surface flux supply. The circulation driven by the radiative cooling then pushes convection aggregating, which is the dry-radiation pathway. In VVM, CSA develops due to the rapid strengthening of circulation driven by convective systems in the moist region, which is the convection-upscaling pathway. The different pathways of CSA development can be attributed to the upscale process of convective structures identified by the cloud size spectrum. The upscaling of large-size convective systems can enhance circulation from the moist region in VVM. In SCALE, the infrequent appearance of large convective systems is insufficient to generate circulation, as compensating subsidence can occur within the moist region even in the absence of convective systems. This study shows that the convective variabilities between models can lead to different pathways of CSA, and mechanism-denial experiments also support our analyses.
A Study of Near-Death Experience in Patients With Chronic Kidney Disease
Authors: N Sai Sameera , P Aishwarya Lakshmi , B Sangeetha Lakshmi , R Ram , V Siva Kumar 
Published: May 2023

Background The near-death experiences (NDE) in dialysis patients of our country have not been previously studied. The objective of this study is to investigate the characteristics of NDEs in patients on dialysis. Materials and Methods We performed a cross sectional study of the adult patients of chronic kidney disease stage 5 without dialysis and on dialysis who survived cardiac arrest by cardiopulmonary resuscitation (CPR) as per ACLS (Advanced Cardiac Life Support) guidelines and who sustained pulseless ventricular tachycardia/ventricular fibrillation and received CPR and/or direct cardioversion. We used two scales, Greyson’s NDE scale and Ring’s Weighted Core Experience Index (WCEI). Results We performed the study between 2016 and 2018. A total of 29 patients were included. The data based on Greyson’s NDE scale and Ring’s Weighted Core Experience Index (WCEI)were collected. Conclusions Our study brings a perspective of NDE in CKD and dialysis patients. A similar study of NDE in dialysis patients should be considered by other nephrologists.
Breaking Light on Economic Divide: How Elementary School Teachers Locate Class Inequality in Teaching and Schools
Authors: Sonu Debbie , Zaino Karen 
Published: May 2023

Background/Context: Macro-analyses have documented the raced and classed consequences of rampant economic inequality in schools and society. However, in educational research, there remain clear gaps in understanding how schoolteachers, especially those working with children, locate the appearances of economic inequality in their teaching and how they make sense of the social conditions that create such disparities. Purpose/Objective/Research Question/Focus of Study: Key to understanding how economic inequality matters in the classroom is acknowledging teachers as critical to disrupting classist relations, cultivating critical awareness, and advocating on behalf of and in solidarity with those who face the brunt of ongoing systems of racial capitalism and coloniality. Equally critical is how the role of teaching can challenge the neoliberal belief that market principles are the best and only way to shape the impending future. To that end, the purpose of this project was to analyze the process of elementary school teachers in New York City as they materialize a more robust understanding of class formation as a part of lived experience and to advance new possibilities for harnessing the teaching of economics as a means toward racial and social justice. Research Design: As part of this larger project, we asked 57 New York City teachers in grades 1–5 to share responses to Likert and open-ended questions, and analyzed a subset of data along two primary lines of inquiry: In what ways does social class appear in your classroom? Describe a moment in your classroom or school when social class mattered. Through a constructivist grounded analysis, we surfaced four overlapping locations: (1) disparities in material possessions and access among students; (2) tensions between teachers, parents, and families; (3) inequalities built into school-based structures and practices; and (4) teachers’ own subjective histories with social class. Conclusions/Recommendations: Given the dearth of scholarship in this area, particularly at the elementary level, we argue for greater attention to the experiences of teachers as they work within institutions marred by racial capitalist society. Elementary school teachers are keenly aware of how material infrastructures and the extraction of value in and through education present grave inequalities for their students and families. They express genuine interest in deepening their understanding of economic inequality and for spaces to explore ways in which they can respond to the everyday events they shared in this study.
Can COVID-19 pandemic surveillance reduce nosocomial urinary infections in urologic surgery?
Authors: Serretta Vincenzo , Mannone Piero , Baiamonte Davide , Armenio Angelo , Lamartina Marcello , Scalici Giuseppe , Simonato Alchiede 
Published: May 2023

Introduction: Since COVID-19 pandemic spread, strict preventive measures were adopted to reduce the risk of transmission. Antiseptic dispensers for hand hygiene were diffusely available for patients and hospital staff. To investigate the prophylactic role played by the strict antiseptic rules adopted during pandemic, the rates of nosocomial urinary infections in 2019 and 2020 were compared. Materials and methods: Patients’ clinical pre-operative characteristics, symptoms, fever, and laboratory data were recorded pre- and post-operatively. Urological surgery was classified in five categories: 1. major surgery 2. upper urinary tract endoscopy, 3. lower urinary tract endoscopy, 4. minor surgery, and 5. Nephrostomy and ureteral stenting. Clavien-Dindo complication score was used. Statistical analysis was performed with R 3.4.2 software. Results: Out of 495 patients, 383 (57.1%) underwent surgical intervention in pre-pandemic March–May 2019 period and 212 (42.9%) in the same pandemic 2020 interval. Preoperatively, 40 (14.1%) and 11 (5.2%) and 77 (27.3%) and 37 (17.5%) patients had fever ( p < 0.003) and leukocytosis ( p < 0.02), in 2019 and 2020 respectively. Urine culture was positive in 29 (10.2%) and 13 (6.2%) patients respectively ( p = 0.22). Post-operatively, 54 (19.1%) and 22 (10.4%) patients and 17 (6.1%) and 2 (0.6%) patients showed fever ( p < 0.003) and positive urineculture ( p < 0.03), in 2019 and 2020 respectively. Discussion and conclusion: Preoperative and post-operative clinical and laboratory signs of nosocomial urinary infection showed a statistically significant lower incidence during the pandemic period in 2020. This observation could be ascribed to the strong preventive measures, to the medical staff high adherence to hygiene and the diffuse availability of hand sanitizers.
Reliability of Cone Beam Weightbearing Computed Tomography Analysis of Total Ankle Arthroplasty Positioning and Comparison to Weightbearing X-Ray Measurements
Authors: Efrima Ben , Barbero Agustin , Ovadia Joshua E. , Indino Cristian , Maccario Camilla , Usuelli Federico Giuseppe 
Published: May 2023

Background: The current reference standard for postoperative evaluation of total ankle arthroplasty (TAA) positioning, weightbearing radiography (WBXR), is subject to technical bias. Weightbearing cone beam computed tomography (WBCT) enables visualization of the foot’s complex 3-dimensional (3D) structure under standing load. To date, no WBCT-based system for TAA positioning has been validated. The purpose of this study was to (1) assess TAA positioning using WBCT 3D models and (2) evaluate the agreement levels between 2 raters and thus evaluate the intermethod reliability with respect to WBXR. Methods: Fifty-five consecutive patients were retrospectively reviewed. Two raters independently created a 3D WBCT model using dedicated software and recorded the following measurements: α angle, tibiotalar surface angle (TSA), hindfoot angle (HFA), tibiotalar ratio (TTR), β angle, γ angle, and Φ angle. Measurements were repeated 2 months apart in similar, independent fashion and compared to WBXR. Interobserver, intraobserver, and intermethod agreements were calculated. Results: All 7 measurements showed good to excellent intraobserver and interobserver reliability (ICC 0.85-0.95). The intermethod (WBCT vs WBXR) agreement showed good agreement for the γ angle (ICC 0.79); moderate agreement levels for the α angle, TSA angle, β angle, and TTR (ICC 0.68, 0.69, 0.70, and 0.69, respectively); poor agreement for the HFA (ICC 0.25); and negative agreement for the φ angle (ICC −0.2). Conclusion: Position analysis of TAA using WBCT demonstrated good to excellent interobserver and intraobserver agreement and can be reliably used. Additionally, a negative to moderate agreement between standard WBCT and standard WBXR was found. Level of Evidence: Level III, retrospective study.
Combined use of pembrolizumab and lenvatinib: A review
Authors: Eisinger Casey , Muluneh Benyam 
Published: May 2023

Objective The purpose of this article is to review the pharmacology, safety, evidence for current use, and potential futures uses for combination therapy with pembrolizumab and lenvatinib. Data Sources A literature review was carried out through PubMed to identify ongoing trials evaluating use, efficacy, and safety of combination pembrolizumab and lenvatinib. NCCN guidelines were utilized to identify current approved uses in therapy and medication package inserts were used to identify pharmacology and preparation requirements. Data Summary A total of five completed clinical trials and two ongoing trials were evaluated for use and safety of pembrolizumab with lenvatinib. Data suggests that combination therapy with pembrolizumab and lenvatinib can be used first line for clear cell renal carcinoma in patients with favorable risk or intermediate/poor risk and in endometrial carcinoma as a preferred second-line regimen for recurrent or metastatic disease for biomarker-directed systemic therapy in non-MSI-H/non-dMMR tumors. This combination may have potential for use in unresectable hepatocellular carcinoma and gastric cancer. Conclusions Use of non-chemotherapy containing regimens spare patients from extended durations of myelosuppression and reduce the risk of infection. Additionally, pembrolizumab with lenvatinib demonstrates efficacy as first line treatment in clear cell renal carcinoma, second line in endometrial carcinoma, and several potential uses on the horizon.
C4d Staining Is Present in Normal Placentas From Pregnancies Prior to Pregnancy Loss Associated With Chronic Histiocytic Intervillositis and Is Reduced by Immunomodulatory Therapy in Subsequent Pregnancies
Authors: Chan Elaine S. , de Koning Lawrence , Yu Weiming , Chadha Rati 
Published: May 2023

Introduction: Chronic histiocytic intervillositis (CHI) is associated with adverse pregnancy outcomes and high recurrence risk. Recent studies suggest that CHI may represent a host-vs-graft rejection, and that C4d immunostain can be used as a marker for complement activation and antibody-mediated rejection in the CHI. Materials and Methods: This retrospective cohort study focused on 5 fetal autopsy cases associated with CHI (5 index cases) from 5 women. We analyzed placentas from the index cases (fetal autopsy cases associated with CHI) and placentas from the women’s previous and subsequent pregnancies. We assessed the presence and extent of CHI and C4d immunostaining in these placentas. We evaluated each available placenta and graded the severity of CHI as either <50% or ≥50%. Additionally, we conducted C4d immunostaining on one representative section from each placenta and graded the staining levels as follows: 0+ for staining <5%; 1+ for staining between 5% and <25%; 2+ for staining between 25% and <75%; and 3+ for staining ≥75%. Results: Three of the 5 women had pregnancies prior to their index cases (fetal autopsy cases associated with CHI). Despite the absence of CHI in their initial pregnancies, the placentas displayed positive C4d staining with grades of 1+, 3+, and 3+, respectively. These results suggest the presence of complement activation and antibody-mediated rejection in placentas from their prior pregnancies without CHI. Three of the 5 women received immunomodulatory therapy after experiencing pregnancy losses associated with CHI. After treatment, 2 of these women had live births at 35 and 37 gestational weeks, respectively, while the third had a stillbirth at 25 gestational weeks. The severity of CHI and the degree of C4d staining in the placentas decreased in all 3 cases following immunomodulatory therapies. Specifically, the level of C4d staining decreased from 3+ to 2+, 2+ to 0+, and 3+ to 1+ in these 3 cases, respectively. Discussion: In women with a history of recurrent pregnancy loss associated with CHI, C4d immunostaining was present in the placentas from their previous non-CHI pregnancies, suggesting activation of the classical complement pathway and antibody-mediated reaction in their prior non-CHI pregnancies before the development of CHI in subsequent pregnancies. Immunomodulatory therapy may improve pregnancy outcomes by reducing complement activation, as shown by the reduction of C4d immunopositivity in the placentas after immunomodulatory treatment. Although we believe that the study provides valuable insights, we acknowledge that there are limitations to the findings. Therefore, to further elucidate the pathogenesis of CHI, additional research efforts with a collaborative and multidisciplinary approach are necessary.
Association of Psoriasis With Hearing Loss: A Systematic Review and Meta-Analysis
Authors: Ger Tzong-Yun , Lien Kuang-Hsu , Chi Ching-Chi 
Published: May 2023

Background The relation between psoriasis and hearing loss has been unclear. Objective To investigate the association of psoriasis with hearing loss. Methods We searched MEDLINE and Embase on 12th November 2022 for studies on the association between psoriasis and hearing loss. We conducted a random-effects model meta-analysis to calculate pooled mean difference (MD) in the pure tone thresholds, pooled odds ratio for sensorineural hearing loss, and pooled hazard ratio for sudden sensorineural hearing loss related to psoriasis. Results We included 12 case-control/cross-sectional and 3 cohort studies with 202,683 subjects. Psoriasis was associated with hearing loss at 500 Hz (pooled MD 2.21, 95% CI (CI) 0.13 to 4.29), 1000 Hz (pooled MD 2.97, 95% CI 1.01 to 4.93), 2000 Hz (pooled MD 5.13, 95% CI 2.45 to 7.82), 4000 Hz (pooled MD 9.3, 95% CI 5.1 to 13.51), and 6000 Hz (pooled MD 11.04, 95% CI 5.05 to 17.03). Patients with psoriasis had increased odds for sensorineural hearing loss (pooled odds ratio 3.85, 95% CI 1.07-13.9) and risk for sudden sensorineural hearing loss (pooled hazard ratio 1.45; 95% CI 1.22-1.71). Conclusion Psoriasis is associated with hearing loss, especially at high frequencies.
Vocational education in Sweden and youth transitions to working life – Challenges and possibilities in the light of a local follow-up study
Authors: Olofsson Jonas , Panican Alexandru 
Published: May 2023

The basis of this article is a follow-up study of a cohort of pupils in the third largest city of Sweden, Malmö. The pupils finished fourth grade at compulsory school in 2008. We have data about every individual in the cohort as well as corresponding information about their parents. The information concern educational choices, educational accomplishments, employment relations, incomes from work and different kinds of social benefits and allowances. We got annual data on these variables from 2008 until the last follow-up year 2019 when most of the individuals were 21 years old. Most of them left upper secondary school in 2017 when they were 19 years old. They were therefore in the beginning of their transition 2019, either aiming for education or work. The results show that vocational education generated favourable conditions for work and incomes provided that the diploma goals ware reached. Individuals with foreign background and with unfavourable socioeconomic origins were overrepresented among those that didn’t reach the diploma goals; this was true for students on VET-programmes as well as higher education preparatory programmes. It should also be mentioned that experiences from a national programme in upper secondary school generally improved conditions for establishment. Those that didn’t reach the goals of compulsory school and weren’t eligible for studying at a national programme met the greatest difficulties in finding jobs and decent income levels.
Creating Patient Context: Empathy and Attitudes Toward Diabetes Following Virtual Immersion
Authors: Wardian Jana L. , Wells Tessa M. , Cochran Teresa M. 
Published: May 2023

Background: Pandemic circumstances created challenges for doctor of physical therapy (DPT) students to understand social determinants of health (SDH) in clinical rotations. Instead of canceling clinical rotations, a virtual reality cinema (cine-VR) education series was implemented. The purpose of this project is to describe the effect of this simulated immersion on student empathy and attitudes toward diabetes. Method: The DPT students (n=59) participated in 12 cine-VR education modules, completing surveys at three time points as part of coursework. The students completed baseline measures of the Diabetes Attitude Scale–Version 3 (DAS-3) and Jefferson Empathy Scale (JES), and then were immersed in 12 cine-VR modules. One week after module completion, students participated in a class discussion about the modules. The students repeated the JES and DAS-3 scales at postclass and six weeks later. Three subscales from the Presence Questionnaire (PQ) were used to measure the virtual experience. Results: Student scores on three DAS-3 subscales significantly improved on posttest: Attitude toward patient autonomy, Mean: 0.75, SD: 0.45; t(58) = 12.742, P < .001; Psychosocial impact of diabetes, Mean: −0.21, SD: 0.41; t(58) = −3.854, P < .001; and Seriousness of type 2 diabetes, Mean: −039, SD: 0.44; t(58) = −6.780, P < .001, with lower scores six weeks later. Student scores increased on the JES and remained high ( P < .001). High subscale scores on the PQ demonstrated immersion and involvement in the virtual experience. Discussion: These modules can allow for a shared student experience that improves diabetes attitudes, increases empathy, and fosters meaningful classroom discussion. The cine-VR experience is flexible, and modules allow students to engage in aspects of a patient’s life that were not available otherwise.