bluuebunny/crossref_metadata_2025_split huggingface dataset:
Overpopulation and Individual Responsibility
Authors: Conly Sarah 
Published: April 2022

Abstract
The world is threatened by overpopulation. Current predictions are for a population rise within a hundred years that seems radically unsustainable on this planet. However, some people oppose controls on how many children people have. I argue that one reason for that is that no individual child will itself cause the environmental havoc that overpopulation will wreak. While we are willing to interfere with the use of the body to prevent a great harm—we can arrest you if you are trying to assault someone—we think we should respect people’s bodily autonomy if the threat they pose is small. I argue that while it is true that each increment of population in itself does no harm, we, as individuals, are nonetheless morally responsible for overpopulation if we have too many children. The fact that we share moral responsibility for the damage caused by overpopulation does not mean that each of us then bears less: moral responsibility does not “divide” according to the number of perpetrators. Since overpopulation constitutes a great harm, interference with the individual is then warranted and states can use certain forms of coercion to stop people from reproducing unsustainably.
Our Intuitive Grasp of the Repugnant Conclusion
Authors: Gustafsson Johan E. 
Published: April 2022

Abstract
According to Total Utilitarianism, a first outcome is at least as good as a second outcome if and only if the sum total of well-being in the first is at least as great as the sum total of well-being in the second. Total Utilitarianism implies the Repugnant Conclusion, which says that, for every population consisting of ten billion people with very high well-being, there is a population consisting of a very large number of people whose existence would be better even though its members have lives that are barely worth living. The Repugnant Conclusion is counter-intuitive. But is this intuition reliable as evidence against Total Utilitarianism? A potential defense of Total Utilitarianism is that our intuition is unreliable in this case because the Repugnant Conclusion involves very large numbers. This chapter considers some earlier proposals of this kind and proposes a variation based on the idea that the unreliability of our intuition about the Repugnant Conclusion is due to a slight insensitivity in our intuitive grasp of the morally relevant factors.
Climate Change and Population Ethics
Authors: Broome John 
Published: April 2022

Abstract
Climate change will certainly alter the world’s future people. Moreover, the alteration may be very large. There is even a slight possibility that it will cause the extinction of humanity, so that after some future date there will be no more people ever. A correct assessment of the harm done by climate change or of the benefit of policies aimed at controlling climate change must take account of the resulting change of population. Yet in the practice of policy no assessment ever does so. This practice of policy-makers concerned with climate change simply continues the common practice of policy-makers in general. It is very rare for policy-makers to take account of the effects of their policies on population. Why? Because they assume, in common with most people, that changes in population are in themselves ethically neutral: they do not make the world either better or worse. This “intuition of neutrality” seems a good reason for ignoring changes in population when making evaluations. But actually, it is not a good reason. I shall explain that, even to the extent that the intuition is true, it does not mean that changes in population can be ignored in making assessments. Changes in population must be taken into account. Yet is difficult to do so, given that the theory of population ethics is in disarray.
Theoretical and Practical Aspects of Cross-Cultural Corpus Studies
Authors: London Justin , Jacoby Nori , Polak Rainer 
Published: April 2022

Abstract
Corpus-based research has historically consisted primarily of data that can best be represented in Western musical notation, often with an American/Eurocentric bias. In this chapter, the authors present a corpus of live performances of jembe-drum ensemble music from Mali and two analytical studies that make use of it. These studies help us to understand and appreciate a musical style of considerable rhythmic subtlety and complexity, and, because they shed additional light on issues of rhythm perception and performance, they also increase the cultural diversity of empirical musicological research. The authors’ findings demonstrate the usefulness of a cross-cultural perspective for both general, scientifically informed theories of rhythm and meter and for ethnomusicologically informed theories of rhythm and meter in African (sub-Saharan) music-cultural contexts.
Innovation in the Study of Superdiversity
Authors: Negrón Rosalyn 
Published: April 2022

Abstract
Empirically, superdiversity, which has to do with the social organization of difference in complex urban settings, has characteristics that challenge ethnographic observation and interviewing research methods that have been traditionally employed in urban, migration, and transnational studies. Instead, Vertovec (2020), Blommaert (2015) and others challenge scholars to think about superdiversity in terms of complexity. How do we translate complexity thinking into research practice? The answer is innovative methods. This chapter first provides a framework for thinking about methodological innovation in the study of complex social environments in urban settings. It then outlines innovative methods to meet the challenges of research on urban social complexity, matching different methods with features of complexity that have special relevance for superdiversity. These include multiplicity of agents or variables; diversity in agents’ or variables’ characteristics; interdependence of agents and variables; high outcome-contingency; unpredictable, nonlinear, multicausal trajectories; emergent conditions, systems, and dynamics; and self-organizing dynamical systems.
Identity Politics in Contexts of Superdiversity
Authors: Geldof Dirk 
Published: April 2022

Abstract
The process of normalization of superdiversity in Western European countries goes together with a rising interest for identity politics—ranging from nationalist and populist counterreactions against increasing diversity and the fear of losing the national identity, to debates over decolonization and the search for identity in contexts of diaspora or majority-minority cities. This chapter explores in which ways superdiversity challenges monolithic and static approaches to identity, and contributes to understanding complex and multiple identities, as well as (competing) claims for recognition.
Human Rights, Intersectionality, and Superdiversity
Authors: Henrard Kristin 
Published: April 2022

Abstract
Investigations of how a superdiversity angle might lead to changed interpretations of legal concepts could be undertaken in various fields of law. This chapter zooms in on “intersectional discrimination” because the prohibition of discrimination is an essential tool for (analyzing) legal approaches to population diversity and because intersectionality is conceptually aligned with superdiversity. Indeed, both concepts alert us to the lack of homogeneity of ethnic groups and the multiple axes of differentiation within these groups. This chapter proceeds along three themes. First, it highlights the importance of intersectional discrimination for a richer nondiscrimination analysis. Second, it explores what a proper (explicit or implicit) identification of intersectional discrimination and a suitable assessment thereof would be. Third, it highlights the hesitation, even reluctance, of a range of international courts and quasi-courts to actually proceed as necessary. The analysis shows obvious differences of degree concerning the extent to which the United Nations treaty bodies, the European Court of Human Rights, and the Court of Justice of the European Union are even willing to identify intersectional discrimination, let alone properly evaluate it. By way of conclusion, the chapter identifies an urgent need to develop a comprehensive methodology for assessing instances of intersectional discrimination. The latter methodology is essential to develop nondiscrimination laws and policies that are suitable for superdiverse societies.
The Polls—Trends
Authors: Jardina Ashley , Ollerenshaw Trent 
Published: April 2022

AbstractPublic opinion research has long demonstrated that white Americans are generally resistant to racially egalitarian policies. Using decades of national public opinion data, we re-examine opinion on race policy in the wake of considerable polarization and shifts in racial attitudes across white partisans. We find that white Democrats have in recent years shown both increasingly liberal racial attitudes and a marked increase in support for policies promoting racial equality that at times rivals the levels of support expressed by Black Americans. We also find, however, that these trends among white Democrats are tempered by heightened levels of racial resentment and continued opposition to racially egalitarian policies among white Republicans. Today, partisans appear to be far more polarized on matters of race and racism than at any point in the last three decades.
OA21 Continuing specialist care beyond age 16 in young people with juvenile idiopathic arthritis: a descriptive study using electronic health records in England
Authors: Costello Ruth E , Kearsley-Fleet Lianne , McDonagh Janet E , Hyrich Kimme , Humphreys Jenny H 
Published: April 2022

Abstract

Background/Aims
It is estimated that juvenile idiopathic arthritis (JIA) persists into adulthood in at least one-third of patients, but it is unclear how frequently hospital services are used beyond age 16. This study aimed to describe characteristics related to continued specialist care in young people (YP) with JIA using electronic health records (EHR) in England.

Methods
YP with JIA were identified from primary care EHR (Clinical Practice Research Datalink GOLD and Aurum databases combined) between 2003 and 2018. JIA was identified if they had a Read code for JIA and either &gt; =3 Hospital Episode Statistics (HES) outpatient specialist care (rheumatology/ophthalmology) appointments or a HES inpatient admission coded with JIA, prior to age 16. Further, cases needed to have linkage to HES data, registration at the same GP for &gt;1 year beyond age 16. Cases were followed from the earliest of first Read code or first HES outpatient appointment until leaving their GP or end of 2018. YP with &gt; =1 specialist care outpatient appointment beyond age 16 were identified. YP were considered discharged from specialist care (a proxy for disease remission) if they had &gt; =1 year between the last appointment and end of study follow-up. Patient characteristics and characteristics of discharged are presented, stratified by continued specialist care.

Results
Of 1095 YP eligible for the study, followed for a median of 12 years beyond 16, 774 (70.7%) continued specialist care beyond age 16. These patients were older at first JIA code and more likely to be female (Table 1). Overall, 543 (51.9%) continued in specialist care beyond age 18. The median age of the last visit was 14 for those not continuing specialist care and 18 for those discharged after the age of 16. Disease duration was longer in those discharged after age 16.

Conclusion
Over two-third of patients with JIA continue to have hospital visits beyond age 16. Of those, however, approximately one-third were discharged from specialist care by the age of 18. These data provide important information for YP with JIA and their families, as well as clinicians running, developing and planning young adult services in paediatric and adult rheumatology.

Disclosure
R.E. Costello: None. L. Kearsley-Fleet: None. J.E. McDonagh: None. K. Hyrich: None. J.H. Humphreys: None.
OA40 How ethnicity influences outcomes in early inflammatory arthritis - equality but not equity: findings from a national cohort
Authors: Adas Maryam , Balachandran Sathiyaa , Esterine Thomas , Amlani-Hatcher Paul , Oyebanjo Sarah , Lempp Heidi , Ledingham Joanna , Galloway James , Kumar Kanta , Dubey Shirish 
Published: April 2022

Abstract

Background/Aims
Patients of Black, Asian and Minority Ethnic (BAME) backgrounds are more likely to report poorer health and low life expectancy. Focusing on patients with early inflammatory arthritis (EIA), we used the National Early Inflammatory Arthritis Audit (NEIAA) to evaluate the relationship between ethnicity, clinician and patient reported outcomes against the seven quality metrics set out in NICE (National Institute for Health and Clinical Excellence) quality standard QS33.

Methods
The study is an observational cohort design. Data were from adult patients newly diagnosed with EIA first seen within rheumatology services in England and Wales between May 2018 and March 2020. Ethnicity was grouped into the following binary categories of ethnic minority groups: BAME (including Black British/African/Caribbean, Asian/Asian British, mixed, other) and White. Analyses were performed on sociodemographic, quality metrics, clinical and patient reported outcomes at baseline and three months follow up. Logistic regression was used to calculate the odds of disease remission and meeting quality metrics by ethnicity. Models were adjusted for age, gender, smoking, comorbidity, deprivation, and disease factors (seropositivity, disease severity [DAS28]).

Results
A total of 35,807 patients were included in the analyses. The BAME cohort accounted for 14% of patients and had proportionately more females. Smoking and comorbidity levels were lower. BAME patients were younger and more likely to be seropositive for rheumatoid factor or CCP antibodies. Compared to White patients, BAME patients were more likely to be referred within 3 days of suspicion of EIA and start treatment within 6 weeks. However, BAME patients had lower odds of disease remission at 3 months follow up despite multilevel adjustments and reported more symptoms of depression and anxiety. Detailed data on clinical and patient reported outcomes after 3 months of specialist care are presented in the table below.

Conclusion
Although there is parity between care delivery for BAME and White patients, BAME patients had worse outcomes in this large multinational cohort. Urgent attention needs to be paid to further investigating the reasons for this and redesigning care pathways to address this inequity.

Disclosure
M. Adas: None. S. Balachandran: None. T. Esterine: None. P. Amlani-Hatcher: None. S. Oyebanjo: None. H. Lempp: Other; HL is the coordinator of the Patient Panel of the NEIAA. J. Ledingham: Other; is a BSR trustee. J. Galloway: Honoraria; has received honoraria from AbbVie, Celgene, Chugai, Gilead, Janssen, Eli Lilly, Pfizer, Roche and UCB. K. Kumar: None. S. Dubey: Other; has been paid financial compensation for educational meeting on impact of ethnicity sponsored by Janssen.
P003 Quality improvement project on rituximab use in rheumatoid arthritis - how do we improve quality and cost effectiveness?
Authors: Ahmad Nadia , McNally Jeremy 
Published: April 2022

Abstract

Background/Aims
Rituximab (RTX) is a chimeric monoclonal antibody against CD20, a transmembrane protein on B lymphocyte surfaces. It is now established as an effective treatment for rheumatoid arthritis (RA). The timing of re-treatment is not well defined and varies widely in clinical practice. Our aim was to assess departmental practice on retreatment doses and frequency of RTX in RA patients. We proposed retreatment with reduced dose (1gm) as compared to the standard dose (1gm x 2, 2 weeks apart). We envisage this would maintain efficacy and lead to significant cost saving for the CCG and Rheumatology department.

Methods
Data were collected retrospectively over 3 years (2017- 2020) on patients who had received at least one re-treatment RTX dose no less than 24 weeks after first course of standard regime. Information was obtained on patient demographics, serology, disease activity scores, previous treatment, concurrent therapy including steroids, frequency and dosing of RTX.

Results
50 patients were included with an average age 66 years (range 32- 85), 58% were females, 83% were seropositive and 59% had established erosive disease. Most patients had received prior therapy of non-biologic and biologic DMARDs, methotrexate and anti-TNF being the most used agents in 70% and 52%, respectively. 40% were biologic DMARD naïve mostly due to anti-TNF contraindication. 78% patients were receiving concomitant non-biologic DMARDs, methotrexate being the commonest in 50% patients. 16% were on steroids with dose ≤ to 5mg in 87% of patients. 43% of patients received RTX 6 monthly, 33% 6- 9 monthly and 24% &gt; 9 months. 96% of the patients received 1gm infusion x2, 2 weeks apart.

Conclusion
Our data showed most patients were receiving standard retreatment regime (1gm x2 fortnightly) at 6 monthly intervals. Previous studies including SMART (Study of Re-treatment With MabThera), SERENE, IMAGE and MIRROR trials suggested reduced dose of RTX had similar clinical efficacy to the standard dose. We optimised retreatment schedule of RTX from 2g to 1g, thereby reducing infection risk, especially in view of the COVID-19 pandemic and achieving significant cost savings. The cost savings over 3-year cycle of treatment for a DGH is of the order of £236,927.

Disclosure
N. Ahmad: None. J. McNally: None.
P022 Audit of vitamin D and calcium level monitoring in sarcoidosis patients taking calcium and/or vitamin D supplements
Authors: Gunawardana Shannon , Nagra Deepak , Bechman Katie , Birring Surinder , Galloway James , Patel Amit 
Published: April 2022

Abstract

Background/Aims
Sarcoidosis is a chronic inflammatory disorder, for which steroids are a common treatment. A side effect of long-term steroid therapy is an increased risk of osteoporosis, and calcium and/or vitamin D supplementation may be indicated. In sarcoidosis patients, increased expression of 1α-hydroxylase triggers the conversion of 25(OH)D3 to 1,25(OH)2D3 (calcitriol). Therefore, monitoring of calcium and vitamin D levels are recommended for patients taking supplementation, as they are at increased risk of hypercalcemia.

Methods
We conducted a retrospective analysis on community measurements of serum calcium and vitamin D levels, in sarcoidosis patients, who were prescribed calcium and/or vitamin D supplementation. Patients with biopsy confirmed sarcoidosis were identified using the King’s College Hospital sarcoidosis database and electronic primary care records were reviewed for each patient.

Results
The database identified 431 patients with biopsy confirmed sarcoidosis, of whom 102 patients (24%) had been prescribed calcium and/or vitamin D supplementation and were further evaluated. Of these 102 patients, 63 (62%) were taking calcium and vitamin D supplementation simultaneously; and 39 (38%) were taking vitamin D supplementation alone. In the last 12 months, 46 patients (45%) had measurements of serum calcium and vitamin D levels taken in the community. One patient taking vitamin D supplementation was identified as having hypercalcemia.

Conclusion
This audit has found infrequent monitoring of serum calcium and vitamin D levels over the last 12 months, in sarcoidosis patients, who were prescribed calcium and/or vitamin D supplementation. A Clinical Commissioning Group wide prescribing alert has been implemented to alert primary care physicians to the importance of monitoring these levels, to reduce the risk of hypercalcemia.

Disclosure
S. Gunawardana: None. D. Nagra: None. K. Bechman: None. S. Birring: None. J. Galloway: None. A. Patel: None.
P040 A Tale of Three Rashes
Authors: Lee Martin A 
Published: April 2022

Abstract

Background/Aims
Skin rashes are commonly an external marker of internal disease and are often useful in the diagnosis of a variety of systemic diseases managed by rheumatologists. I present a case of a lady who developed three discrete episodes of different skin rashes over the course of two months that represented three different underlying pathologies but were nevertheless intrinsically linked.

Methods
In September 2019, a 42-year-old lady returned from holiday in Thailand with mosquito bites on her arms and legs. She presented to another hospital with fevers, myalgias and severe arthralgias. Her CRP was raised at 128mg/l and she was given intravenous cefuroxime for 3 days followed by oral co-amoxiclav for presumed infected mosquito bites. Shortly after starting the intravenous cefuroxime, she developed a second rash on her torso, arms and legs. She was seen a week after discharge from hospital with ongoing severe arthralgias although her CRP had settled and was prescribed celecoxib 200mg twice daily. In October 2019, she developed pedal oedema and a non-blanching, purpuric rash across her shins bilaterally and presented to out-patient clinic.

Results
In clinic, she complained of widespread large and small joint polyarthralgias but there was no synovitis on examination. An anti-streptolysin O titer (ASOT) was negative but IgM and IgG antibodies to Chikungunya were positive. Her CRP was raised at 22 mg/l and a urinalysis was negative for blood and protein. A diagnosis of Chikungunya fever transmitted by mosquito bites was made followed by a maculopapular drug eruption secondary to cefuroxime and subsequent Henoch Schonlein Purpura (HSP) secondary to recent infection. Her symptoms were treated with a reducing course of prednisolone 40mg once a day and her rashes and arthralgias settled over the course of 2 months. Her urinalysis remained negative for blood and protein throughout.

Conclusion
Chikungunya virus is an arthropod-borne virus that is transmitted by mosquito bites. It can cause fevers, severe polyarthralgias (70-100% of cases) and polyarthritis (44-63% of cases). Chronic arthritis has been reported in 25% to 75% of cases. Chikungunya fever is endemic in parts of Western Africa but is also common in many regions of Asia. Maculopapular drug eruptions are the most common type of drug hypersensitivity reaction and are characterized by a generalised eruption of erythematous macules and/or papules after initiating drug therapy. Maculopapular drug eruptions are common side effects of cephalosporins. HSP is a small vessel leucocytoclastic vasculitis characterized by palpable purpura. The purpuric rash is typically symmetrical and located primarily in pressure dependent areas such as the lower extremities. Many cases of HSP are preceded by an upper respiratory tract infection such as Streptococcus but many other infectious agents have been implicated as possible triggers.

Disclosure
M.A. Lee: None.