bluuebunny/crossref_metadata_2025_split huggingface dataset:
What’s Wrong with Toleration? The Zhuangzian Respect as an Alternative
Authors: Huang Yong 
Published: April 2023

Abstract
Toleration has been almost universally regarded as an indispensable virtue one ought to have when encountering people of races, religions, languages, cultures, genders, and sexual orientations different from one’s own. This is unfortunate, however, because toleration includes objection as one of its necessary components: to tolerate an object means to have objection to it though without interfering with it. However, it is wrong to think we have, and it is wrong for us to have, objection to people simply because of their races, religions, languages, cultures, genders, and sextual orientations different from us. The proper virtue we ought to cultivate in this context is respect as advocated in the Zhuangzi, which is fundamentally different from respect that has sometimes been associated with the very conception of toleration.
Just Roles and Virtues? On the Double Structure of Confucian Ethics
Authors: Roetz Heiner 
Published: April 2023

Abstract
Role ethics is next to virtue ethics one of the two dominant current paradigms to classify Confucian ethics. This article argues that both approaches undersell Confucianism. While roles and virtues are important elements of its ethics, this has a deontological layer that does not address the specific bearer of roles but the human being in general. This layer even prevails in case of conflict. Together and in constant tension with the emphasis on roles and virtues, it forms part of a double structure of Confucian ethics.
Globalization as a Catalyst for the Development and Decline of Empires
Authors: Chumakov Alexander N. 
Published: April 2023

Abstract
The author analyzes the problem of social progress in the context of the historical stages of development: savagery – barbarism – civilization. I show how, under the influence of the Great Geographical Discoveries, the variety of continental empires was replenished with maritime (colonial) empires. Globalization has given them a powerful impetus for their development. Then, from the XX century, empires ceased to meet the requirements of the changed times. The empire, as a form of organization of social life, turned out to be ineffective in the modern global world and entered into an acute phase of antagonistic contradictions with it.
Post-9/11 Veterans’ Pursuit and Completion of Post-secondary Education: Social Connection, Mental Health, and Finances
Authors: Morgan Nicole R. , Aronson Keith R. , McCarthy Kimberly J. , Balotti Brandon A. , Perkins Daniel F. 
Published: April 2023

This study examined how veteran social engagement predicted post-secondary school attainment. Nearly 10,000 post-9/11 veterans, who separated from military service in 2016, were surveyed on the programs/services they used over 4 years following separation. More than half of veterans had obtained a degree within 4 years of separation. A higher proportion of veterans of color and female veterans reported attending only some higher education than White non-Hispanic male veterans. Positive predictors of educational attainment included participating in veterans’ centers and veteran-student organizations, while negative predictors included financial and mental health problems. Implications for veteran-serving programs of post-secondary institutions are discussed.
Principals’ Responses to Student Gun Violence Protests: Deter, Manage, or Educate for Democracy?
Authors: Kwako Alexander , Rogers John , Earl Jennifer , Kahne Joseph 
Published: April 2023

Context: School-based student protests have received little scholarly attention, yet they have the potential to impact the school community, students’ civic development, and larger social movements. Principals are key actors in responding to school-based student protests. As school leaders, principals’ actions affect the outcome of student protests and shape many students’ first experiences as activists. Purpose: This study examines U.S. public high school principals’ responses to school-based student protests in 2018, a year of heightened protest activity in response to gun violence in schools. The purpose of our study is to understand how a national sample of principals responded to student protests and to quantify general trends in their responses. Research Design: Using a mixed methods approach, we surveyed 491 principals during the summer of 2018; follow-up interviews were conducted with 38 principals. Analyses are grounded in the Deter-Manage-Educate framework, a new conceptual framework that we develop in this paper, organized around the three broad goals principals pursue when responding to student protests. Using this framework, we determined how and how many principals deterred, managed, and educated. Results: Findings show that very few principals outright deterred student protests. Nearly all principals managed by setting parameters around protests in an effort to balance students’ right to free speech with concerns for order and safety. A majority of principals also educated, using student protest as an opportunity to encourage civic development. Our findings suggest that an important distinction exists between principals who channel students toward (or away from) a particular manner of protest and principals who facilitate reflection to help students realize their own vision of civic engagement. Implications: This study has implications not only for principals, but also for district leaders and educational leadership organizations: Although many principals receive support for managing the logistical (and legal) challenges of responding to student protests, more attention needs to be directed toward helping principals leverage the educative opportunities that student protest can provide.
Internal Fixation of Unstable Osteochondritis Dissecans of the Knee: Long-term Outcomes in Skeletally Immature and Mature Patients
Authors: Husen Martin , Van der Weiden Goran S. , Custers Roel J.H. , Poudel Keshav , Stuart Michael J. , Krych Aaron J. , Saris Daniël B.F. 
Published: April 2023

Background: Osteochondritis dissecans (OCD) is a disorder originating in the subchondral bone, leading to focal lesions with risk of fragmentation and secondary damage of the articular cartilage. It remains controversial if surgical treatment of such lesions is equally successful in skeletally immature and mature patients. Purpose: To determine (1) the long-term clinical success rate after internal fixation of unstable OCD in skeletally immature and mature patients based on physeal status, (2) if patient-specific and procedural variables influence the risk of failure, and (3) patient-reported outcome measures over time. Study Design: Cohort study; Level of evidence, 3. Methods: A multicenter retrospective cohort study was conducted investigating skeletally immature and mature patients treated for unstable OCD lesions of the knee between 2000 and 2015. The healing rate was assessed by radiological imaging and clinical follow-up. Failure was defined as any definitive reoperation for the initially treated OCD lesion. Results: A total of 81 patients met inclusion criteria, including 25 skeletally immature patients and 56 patients with closed physes at the time of surgery. After a mean follow-up time of 11.3 ± 4 years, 58 (71.6%) patients had healed lesions, whereas the lesions failed to heal in 23 (28.4%) patients. No significant difference in risk of failure was observed based on physeal maturation status (hazard ratio, 0.78; 95% CI, 0.33-1.84; P = .56). Lateral versus medial condylar lesion location conferred an increased risk of failure ( P < .05) for both skeletally immature and mature patients. Multivariate analysis of skeletal maturity status showed that a lateral femoral condylar location was an independent risk factor for failure (hazard ratio, 0.22; 95% CI, 0.1-0.5; P < .05). The mean patient-reported outcome scores (International Knee Documentation Committee [IKDC] score and Knee injury and Osteoarthritis Outcome Score [KOOS]) increased significantly after surgery and remained high at the final follow-up ( P < .05). The final scores (mean ± SD) at a mean follow-up of 135.8 months (range, 80-249 months) were IKDC, 86.6 ± 16.7; KOOS Pain, 88.7 ± 18.1; KOOS Symptoms, 89.3 ± 12.6; KOOS Activities of Daily Living, 89.3 ± 21.6; KOOS Sport and Recreation, 79.8 ± 26.3; and KOOS Quality of Life, 76.7 ± 26.3. Conclusion: The long-term results after internal fixation of OCD fragments show high rates of healing and sustainable subjective improvement of knee function and quality of life. A healing rate of 72% was noted at a mean follow-up of 11.3 years. The stage of skeletal maturity had no significant influence on the rate of failure. Lateral femoral condylar lesion location is an independent risk factor for failure in skeletally mature and immature patients.
Transrectal shear wave elastography for detection of prostate cancer
Authors: Keskin Emin Taha , Kaplanoglu Veysel , Senocak Cagri , Basar Halil , Bozkurt Omer Faruk 
Published: April 2023

Aim: To evaluate the value of transrectal shear-wave-elastography(SWE) to differentiate benign and malignant tissues in patients with suspected prostate cancer. Materials and methods: Between January and May 2019, the study was designed as a prospective clinical study. The SWE value of 504 cores measured before biopsy and the pathology result of each core were used in the statistical analysis. The SWE values of benign and malignant cores were compared according to pathology results. ROC analysis was used to calculate the best cut-off SWE value for differentiating malignancy from benign tissues. Specificity, sensitivity, negative, and positive predictive values (NPV, PPV) were also calculated for cut-off value. Results: Prostate cancer was detected in 74 (14.7%) of 504 core biopsies. The mean SWE values were found significantly higher in malignant cores (71.1 kPa) than benign cores (42.3 kPa) ( p < 0.001). Cores with gleason score 7 had a significantly higher SWE value than Gleason score 6 ( p = 0.009). The cut-off value to differentiate malignancy and area-under-curve were calculated 35.85 kPa, 0.733, respectively. The sensitivity, specificity, NPV, and PPV were 83%, 49%, 78%, and 95%, respectively for 35.85 kPa value. Conclusions: The malignant tissues have significantly higher SWE values. Also high gleason score was shown to be associated with high SWE values. To predict the prostate cancer, the difference of SWE values of between benign and malignant tissues has high sensitivity. In the near future, to prevent unnecessary prostate biopsies, SWE will be part of the standard protocol for prostate imaging.
Retrospective Evaluation of Splenic Artery Embolization Outcomes in the Management of Blunt Splenic Trauma: A Single Centre Experience at a Large Level 1 Trauma Centre
Authors: O’Rourke Colin , McKee Hayley , Wijeyaratnam Darrin O. , Bajwa Jaspreet , Tremblay Lorraine , David Elizabeth 
Published: April 2023

Purpose Retrospective review of splenic artery embolization (SAE) outcomes performed for blunt abdominal trauma. Materials and Methods 11-year retrospective review at a large level-1 Canadian trauma centre. All patients who underwent SAE after blunt trauma were included. Technical success was defined as angiographic occlusion of the target vessel and clinical success was defined as successful non-operative management and splenic salvage on follow-up. Results 138 patients were included of which 68.1% were male. The median age was 47 years (interquartile range (IQR) = 32.5 years). The most common mechanisms of injury were motor vehicle accidents (37.0%), mechanical falls (25.4%), and pedestrians hit by motor vehicles (10.9%). 70.3% of patients had American Association for the Surgery of Trauma (AAST) grade 4 injuries. Patients were treated with proximal SAE (n = 97), distal SAE (n = 23) or combined SAE (n = 18), and 68% were embolized with an Amplatzer plug. No significant differences were observed across all measures of hospitalization (Length of hospital stay: x2(2) = .358, P = .836; intensive care unit (ICU) stay: x2(2) = .390, P = .823; ICU stay post-procedure: x2(2) = 1.048, P = .592). Technical success and splenic salvage were achieved in 100% and 97.8% of patients, respectively. 7 patients (5%) had post-embolization complications and 7 patients (5%) died during hospital admission, but death was secondary to other injuries sustained in the trauma rather than complications related to splenic injury or its management. Conclusion We report that SAE as an adjunct to non-operative management of blunt splenic trauma can be performed safely and effectively with a high rate of clinical success.
Socioeconomic Predictors and Cost of Comorbidity Among Indian Population: A Case of Diabetes and Hypertension
Authors: Rai Neha , Tripathi Tulika 
Published: April 2023

Purpose With changing demography and the increasing burden of chronic diseases comorbidity is becoming a major public health concern. Among various co-occurring disease combinations, diabetes and hypertension are the two most fatal combinations often increasing the risk of multimorbidity, complexity, and cost of treatment. Therefore, this study intends to estimate the prevalence of comorbidity in India and across various socioeconomic groups to identify the higher-risk population. We further analysed the economic burden associated with comorbid conditions of diabetes and hypertension in particular. Data and Methodology This is a cross-sectional study that uses Unit-Level data from the NSSO-75 round (2017–2018). The marginal effect using the logit model is calculated to identify the higher-risk population for the prevalence of comorbidity across socioeconomic and demographic characteristics. The cost of treatment is calculated through descriptive statistics. Results and Conclusion The prevalence of comorbid diabetes and hypertension is 2.06% in India. Heart disease, goiter and thyroid, joint pain, bronchial asthma, and gastric peptic ulcer are the common combinations prevailing among patients with diabetes and hypertension together. Results suggest that the elderly and women are at higher risk of comorbidity. Education and higher economic status are positively associated with it. The cost of treatment increases with comorbidity, and medicine constitutes almost 83.2% of the total medical cost among patients with diabetes and hypertension.
Child and Adolescent Mental Health Services in Australia: A descriptive analysis between 2015–16 and 2019–20
Authors: Brazel Matthew , Allison Stephen , Bastiampillai Tarun , Kisely Stephen R , Looi Jeffrey CL 
Published: April 2023

Objective To provide analysis and commentary on Australian state/territory child and adolescent mental health service (CAMHS) expenditure, inpatient and ambulatory structure and key performance indicators. Method Data from the Australian Institute of Health and Welfare and the Australian Bureau of Statistics were descriptively analysed. Results Between 2015–16 and 2019–20, overall CAMHS expenditure increased by an average annual rate of 3.6%. Per capita expenditure increased at a higher rate than for other subspeciality services. CAMHS admissions had a higher cost per patient day, shorter length of stay, higher readmission rate and lower rates of significant improvement. Adolescents aged 12–17 had high community CAMHS utilisation, based on proportion of population coverage and number of service contacts. CAMHS outpatient outcomes were similar to other age-groups. There were high rates of ‘Mental disorder not otherwise specified’, depression and adjustment/stress-related disorders as principal diagnoses in community CAMHS episodes. Conclusions CAMHS inpatient admissions had lower rates of significant improvement and higher 14-day readmission rates than other ages. Australia’s young population had a high outpatient CAMHS contact rate. Evidence-based modelling of CAMHS providers and outcomes may inform future service improvement.
‘Make Them Wonder How You Are Still Smiling’: The Lived Experience of Coping With a Brain Tumour
Authors: Zanotto Anna , Goodall Karen , Ellison Marion , McVittie Chris 
Published: April 2023

A brain tumour can be a life-threatening illness and cause unique symptoms compared to other types of cancer, such as cognitive or language deficits, or changes in personality. It is an exceptionally distressing diagnosis which can affect quality of life, even for those with a low-grade tumour or many years after the diagnosis. This study sought to gain an in-depth understanding of the lived experience of adjustment to living with a brain tumour. Twelve individuals (83% female) with a primary brain tumour (83% low-grade) took part in the study. Participants were aged 29–54 years, on average 43 months following the diagnosis, and were recruited through the charitable support organisations in the United Kingdom. In-depth semi-structured interviews were conducted, transcribed verbatim, and analysed using interpretative phenomenological analysis (IPA). Six inter-related themes were identified: making sense of the diagnosis, seeking empowerment, feeling appreciative, taking charge of coping, learning to accept, and negotiating a new normality. Notions of empowerment, gratitude, and acceptance throughout the illness journey were prominent in the participants’ narratives. Receiving sufficient information and initiating treatment were important in negotiation of control. The results highlighted what facilitates and hinders adaptive coping. Aspects which facilitated positive coping were as follows: trust in clinician, feeling in control, feeling grateful, or accepting. Participants on a ‘watch and wait’ approach, while feeling appreciative, perceived the lack of treatment as difficult and frustrating. Implications for patient–clinician communication are discussed, particularly for patients on a ‘watch and wait’ who might need additional support in adjusting.
Dicer Suppresses Hepatocellular Carcinoma via Interleukin-8 Pathway
Authors: Han Xin , Wu Jianhua , Sha Ziyue , Lai Ruixue , Shi Jianfei , Mi Lili , Yin Fei , Guo Zhanjun 
Published: April 2023

Background: Elevated level of interleukin-8 (IL-8) promotes hepatocellular carcinoma (HCC) development and contributes to poor prognosis. Previously, we have proved that Dicer inhibits HCC progression. In this study, we evaluated the potential interaction between IL-8 and Dicer as well as their influence on HCC. Methods: Hepatocellular carcinoma cells of SMMC-7721 were divided into 2 groups for subsequent analysis: pCMV-Dicer group for Dicer-overexpressing lentivirus transfected cells (pCMV-Dicer cells) and pCMV-NC group for empty lentivirus transfected cells (pCMV-NC cells). Cell Counting kit-8 (CCK8), wound healing, and transwell were used to evaluate the inhibitory effect of Dicer overexpression on proliferation, migration, and invasion of HCC cells. The level of IL-8 was measured by flow cytometry bead-based immunoassays. Male nude BALB/c mice injected with pCMV-Dicer or pCMV-NC cell suspensions was used for transplant of HCC tumor. Results: We found that the secretion of IL-8 was reduced in the medium of pCMV-Dicer cells ( P = .027). Recombinant human IL-8 (rhIL-8) reversed the inhibitory effect of Dicer on proliferation ( P < .01), migration ( P = .003), and invasion ( P = .001), whereas IL-8 inhibitor of reparixin enhanced inhibitory effect of Dicer on proliferation ( P < .05), migration ( P = .008), and invasion ( P = .000). Lenvatinib downregulated the IL-8 level of HCC cells ( P = .000) as well as promote Dicer-induced inhibition for HCC cells referring to proliferation ( P < .05), migration ( P = .000), and invasion ( P = .000). Animal experiments also demonstrated that Dicer cooperated with lenvatinib to inhibit the growth of HCC tumors ( P < .05). Conclusions: Dicer cooperated with lenvatinib to inhibit HCC growth via downregulating IL-8, and Dicer displayed its potential capability to enhance the anti-tumor effect of lenvatinib.
Conservative Versus Endovascular Treatment for Spontaneous Isolated Superior Mesenteric Artery Dissection: A Clinical and Imaging Follow-up Study
Authors: Ye Mengmeng , Zhou Qingyun , Wu Jiacheng , Zhang Zheng , Li Bo , Zheng Tao , Shao Guofeng 
Published: April 2023

Purpose: Spontaneous isolated superior mesenteric artery dissection (SISMAD) is a rare vascular disease, the treatment strategies for which remain debated. This retrospective study aimed to compare the outcomes of conservative and endovascular treatments in patients with SISMAD. Materials and Methods: Fifty-eight patients with SISMAD confirmed by computed tomography angiography admitted to our hospital between November 2017 and May 2021 and received confirmed conservative (n=43) or endovascular (n=15) treatment. The patient demographics, imaging analysis, and follow-up results were analyzed and compared. Results: The cohort included 54 males and 4 females with a mean age of 52 years. Abdominal pain was the major complaint (49/58, 84.5%), followed by chest pain (2/58, 3.4%). The mean follow-up was 9.1±7.9 months. The 2 main Sakamoto types were type III (27/58, 46.6%) and type IV (16/58, 27.6%). Most patients in both groups had angle 1 (aortomesenteric angle) and angle 2 (superior mesenteric artery [SMA] course) of over 80°. About 67.3% of patients had long length of dissection (>60 mm). The median distance between the SMA root and the dissection entry site was 1.5 cm, mostly (84.5% of the patients) in the curved segment of the SMA. Telephone follow-ups found that most patients survived pain-free, and none underwent intestinal resection. Only 4 patients, 2 in each group, had recurrent abdominal pain during follow-up and received stenting treatment to achieve complete vascular remodeling. Importantly, we found that the conservative and endovascular therapies achieved similar high remodeling rates (94% and 100%, respectively; p=0.335). The conservative group achieved satisfying vascular remodeling (partial, 35%; complete, 59%), making it as safe and effective a treatment as endovascular therapy. Conclusions: Initial conservative management is safe and effective in patients with SISMAD. A high technical success rate and favorable short-term outcomes were associated with endovascular procedures as secondary interventions. It would be helpful to conduct large-scale, prospective, randomized controlled trials with long-term follow-up for SISMAD. Clinical Impact 1. This research provided more detail clinical information, such as evaluation of abdominal pain and measurements of SMA angles, which is all relevant to treatment. 2. What’s more, the most surprising results of follow-up part shown that conservative treatment could reached the remodeling rate as high as endovascular treatment, which was relatively low in other studies. It helps us share our treatment experience with clinicians. 3. In addition, we get limited knowledge about this rare disease, it’s encouraging us to do more researches based on the results we had.