bluuebunny/crossref_metadata_2025 huggingface dataset:
The hidden emotions of therapists: An autoethnographic exploration of working with clients who self‐injure
Authors: Naxton Joanna
Published: November 2024

Introduction

This paper explores how working with clients who self‐injure generates significant emotional reactions in therapists, often difficult to manage. Drawing on my clinical experience as a researcher and counsellor, I provide an evocative autoethnographic account, highlighting hidden, forbidden or taboo feelings. The aim was to deepen understanding of therapists' emotional realities and contribute to the limited literature on this subject.

Method

Through journaling, sketching, metaphor and field notes, I detail personal experiences with clients who self‐injure. This autoethnography explores my emotions and reactions. A case vignette illustrates my experiences, promoting critical and empathic consideration of how therapist emotions are experienced.

Data Analysis

I use autoethnographic methods to analyse the emotional impact and existential reflections of working with clients who self‐injure, employing layers of qualitative interpretation from various personal data sources.

Results

Findings reveal that working with clients who self‐injure forces me to confront my mortality, evoking deep existential reflections and intense emotions like vulnerability and fear. This disrupts my sense of immortality, highlighting my role's limitations and evoking shame and self‐doubt about my ability to alleviate suffering.

Implications for Practice

This paper advances research on self‐injury and emphasises autoethnography as a valuable avenue for counsellors engaging in research. Grounded in PhD study, this paper makes an original contribution to knowledge. Integrating discussions on mortality and emotional vulnerability into supervision and training is crucial, alongside comprehensive training that addresses emotional and unconscious issues. Accessible supervision fosters growth, reduces stigma and supports therapists working with clients who self‐injure.
Association Between Stress, Neuroinflammation, and Irritable Bowel Syndrome: The Positive Effects of Probiotic Therapy
Authors: Azarfarin Maryam , Moradikor Nasrollah , Matin Somaieh , Dadkhah Masoomeh
Published: November 2024

Stress refers to an organism's response to environmental threats in normal condition to maintain homeostasis in the body. In addition, strong inflammatory reactions induced by the hypothalamic–pituitary–adrenal (HPA) axis under stress condition during a long time. Reciprocally, chronic stress can induce the irritable bowel syndrome (IBS) which is a well‐known gut disorder thereby play an important role in the promotion and pathophysiology of neuropsychiatric diseases. It has been demonstrated that leaky gut is a hallmark of IBS, leads to the entrance the microbiota into the bloodstream and consequent low‐grade systemic inflammation. In the current review, we will discuss the mechanisms by which stress can influence the risk and severity of IBS and its relationship with neuroinflammation. Also, the role of probiotics in IBS co‐existing with chronic stress conditions is highlighted.
Combination of bolus and continuous infusion of factor VIII in a patient with severe hemophilia A undergoing on‐pump coronary artery bypass graft surgery
Authors: Vander Zwaag Stanislaw , Brose Stefan , Fassl Jens
Published: November 2024

Key Clinical Message

Patients with hemophilia A can safely undergo cardiac surgery. Combining continuous infusion and boluses of factor VIII is both safe and cost‐effective. Interdisciplinary approach and meticulous planning are crucial in the prevention of bleeding complications.
Exploring the dual role of endoplasmic reticulum stress in urological cancers: Implications for tumor progression and cell death interactions
Authors: Farahani Najma , Alimohammadi Mina , Raei Mehdi , Nabavi Noushin , Aref Amir Reza , Hushmandi Kiavash , Daneshi Salman , Razzaghi Alireza , Taheriazam Afshin , Hashemi Mehrdad
Published: November 2024

The endoplasmic reticulum (ER) is crucial for maintaining calcium balance, lipid biosynthesis, and protein folding. Disruptions in ER homeostasis, often due to the accumulation of misfolded or unfolded proteins, lead to ER stress, which plays a significant role in various diseases, especially cancer. Urological cancers, which account for high male mortality worldwide, pose a persistent challenge due to their incurability and tendency to develop drug resistance. Among the numerous dysregulated biological mechanisms, ER stress is a key factor in the progression and treatment response of these cancers. This review highlights the dual role of aberrant ER stress activation in urologic cancers, affecting both tumor growth and therapeutic outcomes. While ER stress can support tumor growth through pro‐survival autophagy, it primarily inhibits cancer progression via apoptosis and pro‐death autophagy. Interestingly, ER stress can paradoxically aid cancer progression through mechanisms such as exosome‐mediated immune evasion. Additionally, the review examines how pharmacological interventions, particularly with phytochemicals, can stimulate ER stress‐mediated tumor suppression. Key regulators, including PERK, IRE1α, and ATF6, are discussed for their roles in upregulating CHOP levels and triggering apoptosis. In conclusion, a deeper understanding of ER stress in urological cancers not only clarifies the complex interactions between cellular stress and cancer progression but also provides new opportunities for innovative therapeutic strategies.
Zinc Bioinspired Catalytic System for the Valorization of CO2 Into Cyclic Carbonates
Authors: Dias Hugo , Tuel Alain , Christ Lorraine
Published: November 2024

Cyclic organic carbonates are defined as key compounds for a sustainable chemical economy. Their synthesis from CO2 under mild conditions is a useful way to valorise this greenhouse gas as carbon source. Even if a wide range of catalysts were described to promote the carbon dioxide cycloaddition into epoxides, only few ones concern enzymatic systems. The zinc–l‐histidine active site of carbonic anhydrase inspired the present work, pointing out that the imidazole moiety of the amino acid ligand has a crucial role. An extensive study was undertaken to establish the structure–activity relationship of imidazole derivatives, zinc salts, and their respective catalytic activity in the CO2 cycloaddition reaction. The effect of aromatic, alkyl, or iodine substituents and their position in N‐heterocycles were highlighted. A synergic effect was noted when combining imidazole compounds with zinc salts. The optimization of reaction conditions emphasised the in situ ZnI2–1‐methylimidazole catalytic system, which is selective toward cyclic styrene carbonates and efficient under solvent‐free mild conditions (50 °C, atmospheric CO2 pressure). Once reusing tests confirmed the catalytic system robustness, the reaction scope was enlarged to several epoxides resulting in 84%–99% yields of their corresponding cyclic carbonates.
Pesticides and prostate cancer incidence and mortality: An environment‐wide association study
Authors: Soerensen Simon John Christoph , Lim David S. , Montez‐Rath Maria E. , Chertow Glenn M. , Chung Benjamin I. , Rehkopf David H. , Leppert John T.
Published: November 2024

Background

Prostate cancer is the most common cancer among men in the United States, yet modifiable risk factors remain elusive. In this study, the authors investigated the potential role of agricultural pesticide exposure in prostate cancer incidence and mortality.

Methods

For this environment‐wide association study (EWAS), linear regression was used to analyze county‐level associations between the annual use of 295 distinct pesticides (measured in kg per county) and prostate cancer incidence and mortality rates in the contiguous United States. Data were analyzed in two cohorts: 1997–2001 pesticide use with 2011–2015 outcomes (discovery) and 2002–2006 use with 2016–2020 outcomes (replication). The reported effect sizes highlight how a 1‐standard‐deviation increase in log‐transformed pesticide use (kg per county) corresponds to changes in incidence. Analyses were adjusted for county‐level demographics, agricultural data, and multiple testing.

Results

Twenty‐two pesticides showed consistent, direct associations with prostate cancer incidence across both cohorts. Of these, four pesticides were also associated with prostate cancer mortality. In the replication cohort, each 1‐standard‐deviation increase in log‐transformed pesticide use corresponded to incidence increases per 100,000 individuals (trifluralin, 6.56 [95% confidence interval (CI), 5.04–8.07]; cloransulam‐methyl, 6.18 [95% CI, 4.06–8.31]; diflufenzopyr, 3.20 [95% CI, 1.09–5.31]; and thiamethoxam, 2.82 [95% CI, 1.14–4.50]). Limitations included ecological study design, potential unmeasured confounding, and lack of individual‐level exposure data.

Conclusions

The results of this study suggest a potential link between certain pesticides and increased prostate cancer incidence and mortality. These findings warrant further investigation of these specific pesticides to confirm their role in prostate cancer risk and to develop potential public health interventions.
Effects of a culturally tailored patient navigation program on unmet supportive care needs in Hispanic/Latino cancer survivors: A randomized controlled trial
Authors: Noriega Esquives Blanca S. , Moreno Patricia I. , Munoz Edgar , Lad Thomas E. , Hollowell Courtney M. P. , Benzo Roberto M. , Ramirez Amelie G. , Penedo Frank J.
Published: November 2024

Background

Patient navigation (PN) is a promising yet underused approach to address Hispanic/Latino (H/L) cancer survivors' unmet supportive care needs. The authors conducted a randomized trial to evaluate the effect of a culturally tailored PN program with the LIVESTRONG Foundation's Cancer Navigation Services (PN‐LCNS) on reducing unmet needs in H/L survivors.

Methods

From 2012 to 2015 at two US sites, 288 H/L survivors diagnosed with breast, prostate, or colorectal cancer were randomized to a PN‐LCNS program or to standard PN. Participants assigned to the PN‐LCNS program received 3‐month PN services; access to phone‐based, bilingual, one‐on‐one support; and additional resources (i.e., guidebook, health journal, and care plan). Participants completed assessments at baseline and at 3, 9, and 15 months post‐baseline. The Supportive Care Needs Survey was used to assess unmet needs across five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality. Intervention effects were tested by using separate multilevel growth models for women and men.

Results

Women randomized to the PN‐LCNS program, relative to those who received standard PN, had a statistically significant reduction in unmet needs (i.e., overall and for the health systems and information, physical and daily living, and patient care and support domains). Among men, younger age was associated with greater unmet needs at baseline. Prostate cancer survivors reported greater unmet sexual health needs compared with colorectal cancer survivors. There was no significant change in unmet needs among H/L men.

Conclusions

A culturally tailored PN program can reduce unmet supportive care needs among H/L women cancer survivors. However, interventions specifically targeting unmet needs in H/L men and sexual health are still necessary (ClinicalTrials.gov identifier NCT02275754).

Plain Language Summary

Hispanic/Latino (H/L) cancer survivors often report concerns or needs that are not adequately addressed by the health care team, which could be related to psychological, health system and information, patient care and support, physical and daily living, and sexuality issues.

In this randomized controlled trial of 288 H/L survivors diagnosed with breast, prostate, or colorectal cancer, women assigned to a culturally tailored patient navigation program experienced a reduction in unmet needs compared with those who received standard patient navigation.

H/L men did not experience a change in unmet needs.
Theoretical Insights into Ultrafast Separation of Photogenerated Charges in a Push‐Pull Polarized Molecular Triad
Authors: Szychta Kamil , Martyka Mikołaj , Jankowska Joanna
Published: November 2024

Herein, we propose a purely‐organic donor‐acceptor (D−A) molecular triad, with a light‐absorbing polarized molecular wire (PMW) used as a central linkage, as a proof of concept for the possible future applications of the D‐PMW−A arrangement in molecular photovoltaics. This work builds upon our earlier study on the PMW unit itself, which proved to be highly promising for the ultrafast photogeneration of free charge carriers. Quantum‐chemical calculations performed for the D‐PMW−A triad at a semi‐empirical level of theory reveal a large electric dipole moment of the system, and show strong charge‐transfer (CT) character of its lowest‐energy excited electronic states, including the
, which favours efficient dissociation of an exciton initially formed upon the absorption of light. The confirmation for this effect was found with nonadiabatic molecular dynamics simulations, revealing an ultrafast relaxation from higher, bright excited states to
, completed on a subpicosecond timescale. The architecture of the proposed molecular triad enables its electronic coupling to the surrounding environment through chemical bonds, or noncovalent stacking interactions, which might open way for synthesis of a new class of D‐PMW−A efficient molecular organic photovoltaic materials.
Terminal Sliding Mode Control of Microgrid Inverter Systems
Authors: Wang Zixin , Xiu Chunbo , Cheng Yi , Li Baoquan
Published: November 2024

To enhance the power quality of microgrid inverters and reduce the influence of changes in inductance parameters and external disturbances on the direct power control of the inverter system, a terminal sliding mode control strategy with a variable exponential power reaching law has been proposed. The designed new reaching law comprises a variable exponential term and an enhanced power term. The variable exponential term contains an arctangent function, and the power term coefficient is replaced by a function about the sliding mode. Therefore, the convergence rate can be adaptively adjusted based on different stages of the system, ensuring a faster rate of convergence throughout the process of approaching the sliding mode surface. To weaken the effects of changes in inductance parameters, a power disturbance observer is designed to estimate the internal disturbances induced by the filtered inductance in the system. Subsequently, a sliding mode control law containing disturbance observations is derived. Moreover, a variable exponential terminal sliding surface is designed to adjust the convergence rate of system errors on the sliding surface in stages, thereby enhancing the control performance of the system. The simulation results show that the new reaching law has faster convergence rate and better dynamic performance. The convergence speed of the system error can be accelerated by the designed variable exponential terminal sliding surface. The sliding mode control strategy with the variable exponential power reaching law is applicable to the power control system of three‐phase inverters in microgrids, thereby significantly enhancing the dynamic performance and robustness of the system.
A New Three‐Port DC–DC Converter: Analysis, Design, and Verification for Hybrid Energy Systems
Authors: Malik Muhammad Zeeshan , Zhang Shiqing , Chen Guang , Ali Amjad
Published: November 2024

A research study on the three‐port DC–DC converters is done in this article. The proposed converter is a power electronic unit with a low‐voltage, high‐voltage, and battery port. The power of the input ports can be transferred to the output port simultaneously and individually. In this converter, the power can flow bidirectional. In other words, the battery can be charged not only by the low‐voltage port but also by the returned energy from the high‐voltage port. Hence, the proposed converter can operate in step‐up and step‐down modes. Continuous input current, the low voltage stress on semiconductors, and the low count of the devices are other advantages of the converter. These features and the benefits mentioned above make the proposed converter proper for hybrid energy systems. This converter is analyzed in continuous conduction mode, resulting in mathematical equations. To validate these theoretical analyses, a laboratory scale of the converter performs at 50 kHz, 200 W, and 115 V.
Leakage Current Suppression and Balance Control of Neutral Point Potential for Three‐Level Inverter
Authors: Meng Ningning , Min Yongzhi , Shi Zhilong
Published: November 2024

Nonisolated three‐level inverter has the problem of leakage current and neutral‐point (NP) potential imbalance in photovoltaic grid‐connected system. Therefore, a new subregional vector‐optimized modulation strategy is proposed, which can be adopted to achieve leakage current suppression and NP potential balance control in full power factor and the range of full modulation ratio. First, a system model is established for the three‐level grid‐connected inverter to analyze the mechanism of leakage current and the factors affecting the NP potential. Aiming at the shortcomings of existing modulation strategies, the three‐level space vector modulation region is redivided, and different voltage vector preselection methods are used in different modulation regions, reduced computing power. In addition, controlling the balance of NP potential, the effect of dead zone effect on the leakage current is further analyzed and improved on the basis of the proposed strategy. Finally, the proposed strategy is compared with the traditional space vector pulse width modulation strategy. The experimental results show that the proposed control strategy suppresses the leakage current below 300 mA and can effectively control the NP potential shift and eliminate the midpoint potential fluctuation. Meanwhile, the control strategy is low in computation and fast in seeking the optimum.
A Compact Planar MIMO Inverted‐F Antenna (PIFA) for Sub‐6 GHz 5G Communication and IoT Wireless Networks Applications
Authors: Babu K. Vasu , Sree Gorre Naga Jyothi , Das Sudipta , Ali Wael , Islam Tanvir , EL Ghzaoui Mohammed
Published: November 2024

A compact eight‐port MIMO structure containing planar inverted‐F antennas (PIFAs) as radiating elements is designed for 5G cellular communication applications within the sub‐6 GHz band. The proposed antenna consists of four radiating elements that are placed at four corners on the same plane of geometry. The overall dimension of the ground plane is considered to be 59 mm × 120 mm to make it convenient for modern smart mobile handsets. Each radiating element has 2‐feeding plates, which are situated perpendicular to each other in orientation to make the arrangement cross‐polarized, which in turn exploits polarization diversity as well as spatial diversity among the combination of different radiating elements. The patches are structured by embedding rectangular slots in a meandered shape, and the ground plane is configured by introducing rectangular slots and narrow metallic strips. The prototype of the prescribed MIMO PIFA model has been fabricated and experimentally tested. It shows multi‐band operations (3.27–3.37, 4.16–4.35, 4.93–5.06, and 5.47–5.68 GHz) within the sub‐6 GHz spectrum. The isolation among various patches is observed within the range of −35 dB to −42 dB. The peak gain reaches around 8.1 dBi. The designed MIMO PIFA exhibits superior diversity performance by producing ECC ≤ 0.0006, DG ≈ 10 dB, CCL < 0.20 bits/Hz/s, and MEG ≤ −3 dB. Furthermore, the specific absorption rate (SAR) is evaluated according to the standard values of fat, skin, and muscle at 3.3 GHz. The prescribed model maintains acceptable SAR values for 1‐g and 10‐g tissues, which makes it suitable for smartphone applications.
Potter Cove's Heavyweights: Estimation of Species' Interaction Strength of an Antarctic Food Web
Authors: Rodriguez Iara Diamela , Saravia Leonardo Ariel
Published: November 2024

In the West Antarctic Peninsula, global warming has led to severe alterations in community composition, species distribution, and abundance over the last decades. Understanding the complex interplay between structure and stability of marine food webs is crucial for assessing ecosystem resilience, particularly in the context of ongoing environmental changes. In this study, we estimate the interaction strength within the Potter Cove (South Shetland Islands, Antarctica) food web to elucidate the roles of species in its structure and functioning. We use these estimates to calculate food web stability in response to perturbations, conducting sequential extinctions to quantify the importance of individual species based on changes in stability and food web fragmentation. We explore connections between interaction strength and key topological properties of the food web. Our findings reveal an asymmetric distribution of interaction strengths, with a prevalence of weak interactions and a few strong ones. Species exerting greater influence within the food web displayed higher degree and trophic similarity but occupied lower trophic levels and displayed lower omnivory levels (e.g., macroalgae and detritus). Extinction simulations revealed the key role of certain species, particularly amphipods and the black rockcod Notothenia coriiceps, as their removal led to significant changes in food web stability and network fragmentation. This study highlights the importance of considering species interaction strengths in assessing the stability of polar marine ecosystems. These insights have crucial implications for guiding monitoring and conservation strategies aimed at preserving the integrity of Antarctic marine ecosystems.
Bottom Trawling and Multi‐Marker eDNA Metabarcoding Surveys Reveal Highly Diverse Vertebrate and Crustacean Communities: A Case Study in an Urbanized Subtropical Estuary
Authors: Ip Jack Chi‐Ho , Loke Hai‐Xin , Yiu Sam King Fung , Zhao Meihong , Li Yixuan , Lin Yitao , How Chun‐Ming , Mo Jiezhang , Yan Meng , Cheng Jinping , Lai Vincent Chi‐Sing , Chan Leo Lai , Leung Kenneth Mei Yee , Qiu Jian‐Wen
Published: November 2024

Estuarine habitats serve as critical feeding and nursery grounds for many aquatic species and support fisheries. However, monitoring these complex ecosystems using conventional trawling methods is destructive, costly, and labor‐intensive. This study compared trawling and a multi‐marker environmental DNA (eDNA) metabarcoding approach to monitor marine vertebrate and crustacean communities in an estuarine environment in subtropical Hong Kong. We analyzed 16 bottom trawl samples and the eDNA from 32 two‐liter water samples using primer sets specific to fishes and mammals (MiFish‐U, 12S‐V5, and Berry‐Fish) and decapod crustaceans (MiDeca). We found that the eDNA approach detected more pelagic and demersal fishes (237 vs. 106 in trawling) and elasmobranchs (6 vs. 3) than trawling. The eDNA approach was also more effective than trawling in detecting threatened vertebrates (16 vs. 4), including the Indo‐Pacific Finless Porpoise and the critically endangered Large Yellow Croaker. Among the detected fish at species level, 70 species were detected by both approaches, 32 species were detected by trawling only, and 142 species were detected by the eDNA approach only. Regarding crustaceans, the eDNA approach detected slightly fewer decapods (61 vs. 77) and stomatopods (5 vs. 8) than trawl surveys. However, the eDNA approach could be enhanced through the development of suitable decapod‐specific primers and the expansion of the local reference database. In addition, multivariate analyses of the eDNA data revealed spatial patterns of fish and crustacean assemblages that might be associated with sediment loading, oxygen, and nutrient levels. Furthermore, there was a positive correlation between eDNA read counts and trawl catch, but their correlation coefficient was low. We conclude that eDNA metabarcoding can provide high‐resolution detection of species, composition, and unravel community–environment relationships in estuarine ecosystems. Overall, integrating the non‐destructive eDNA approach can complement the conventional trawling method for better‐informed sustainable fishery management and conservation.
Targeted Electrocatalysis for High‐Performance Lithium–Sulfur Batteries
Authors: Nazir Aqsa , Pathak Anil , Hamal Dambar , Awadallah Osama , Motevalian Saeme , Claus Ana , Drozd Vadym , El‐Zahab Bilal
Published: November 2024

The intricate sulfur redox chemistry involves multiple electron transfers and complicated phase changes. Catalysts have been previously explored to overcome the kinetic barrier in lithium–sulfur batteries (LSBs). This work contributes to closing the knowledge gap and examines electrocatalysis for enhancing LSB kinetics. With a strong chemical affinity for polysulfides, the electrocatalyst enables efficient adsorption and accelerated electron transfer reactions. Resulting cells with catalyzed cathodes exhibit improved rate capability and excellent stability over 500 cycles with 91.9% capacity retention at C/3. In addition, cells were shown to perform at high rates up to 2C and at high sulfur loadings up to 6 mg cm−2. Various electrochemical, spectroscopic, and microscopic analyses provide insights into the mechanism for retaining high activity, coulombic efficiency, and capacity. This work delves into crucial processes identifying pivotal reaction steps during the cycling process at commercially relevant areal capacities and rates.
Chiral Secondary Phosphine Oxide Ligands in Asymmetric Ni−Al Bimetallic Catalysis
Authors: Xu Mengying , Xu Weiwei , Ye Mengchun
Published: November 2024

Ligands play a key role in asymmetric transition‐metal catalysis. Among reported chiral ligands, readily available and air‐stable secondary phosphine oxide ligands are unique and have aroused wide interest in Ni−Al bimetallic catalysis, since they can act as bifunctional ligands to ligate two metals for stronger bimetallic synergism, greatly enhancing reactivity and selectivity. Hence, in this mini review we will focus on secondary phosphine oxides and their applications in asymmetric Ni−Al bimetallic catalysis.
Plasma neurofilament light chain in fibromyalgia: A case control study exploring correlation with clinical and cognitive features
Authors: Ruggieri Maddalena , Paparella Giulia , Clemente Livio , Libro Giuseppe , Gargano Concetta Domenica , de Tommaso Marina
Published: November 2024

Background

Plasma neurofilament light chain (NFL) has been measured as a biomarker of neuronal damage in various neurological disorders. Elevated tau and β‐amyloid levels have been found in patients with fibromyalgia (FM). The aim of the present study was to compare plasma neurofilament levels in fibromyalgia patients with normal controls and to investigate the correlation with clinical features and cognitive tests.

Methods

Plasma NFL levels were assessed in 33 FM patients and compared with 22 age‐matched controls. All patients were also assessed with clinical scales examining fibromyalgia disability, sleep quality and duration, fatigue, anxiety, and depression, and a neuropsychological battery examining executive function, verbal short‐term memory, and working memory, as well as attentional executive function and selective attention, interference sensitivity, and inhibition of automatic responses.

Results

NFL levels were higher in FM patients (controls 6.19± 1.92; FM 17.28± 15.94 pg/mL ANOVA p 0.002). Working memory was the most impaired cognitive function significantly correlated with high NFL scores (Pearson p 0.034). Short sleep times also correlated with higher NFL scores (Pearson p 0.02) and poorer working memory performance (Pearson p 0.02). No correlation was found with indices of disease severity and duration.

Conclusions

Plasma NFL levels are elevated in fibromyalgia patients, suggesting neuronal damage and correlating with a slight decrease in working memory and short sleep duration.

Significance Statement

Plasma neurofilament levels are elevated in patients with fibromyalgia, regardless of disease severity and duration. Neurofilament levels are higher in patients with mild working memory impairment and sleep disorders. Subgroups of patients with primary neuronal damage phenomena could be individualized for prospective evaluation with regard to the possible development of cognitive decline and sleep disturbances, which would justify a tailored therapeutic approach.
Evaluation of self‐stigma in patients with epilepsy: Validation of the self‐stigma scale to Spanish (ESSS‐S)
Authors: Manzanares Isabel , Kuramochi Izumi , Olivera Marta , Centeno María , Khawaja Mariam , Pintor Luis , Donaire Antonio , del Mar Carreño María , Conde‐Blanco Estefanía
Published: November 2024

Objective

The Epilepsy Self‐Stigma Scale (ESSS) has been developed in Japan for patients with epilepsy (PWE). We aimed to validate the scale in Spanish and examine its validity and reliability.

Methods

The transcultural adaptation of the ESSS was conducted using translation and back‐translation, along with pilot testing and an expert panel review. An online questionnaire was used to assess construct validity, criterion validity, and internal consistency.

Results

A total of 260 out of 628 participants completed the questionnaires. We found a two‐factor structure that explained 61.3% of the total variance: factor 1 “self‐perceived discrimination” with a Cronbach's alpha of 0.80, and factor 2 “social isolation” with a Cronbach's alpha of 0.75. The reliability of overall ESSS‐S 8‐item scores was high (Cronbach's alpha = 0.74). Convergent validity was tested and demonstrated a significant correlation. P.

Self‐perceived discrimination scores were associated with higher anxiety and depression scores (r = 0.53/0.54; p < 0.001), lower self‐esteem (−0.53; p < 0.001), and lower quality of life (r = −0.66; p < 0.001). Social isolation scores were associated with higher anxiety and depression scores (r = 0.41/0.33; p < 0.001), lower self‐esteem (−0.34; p < 0.001), and lower quality of life (r = −0.35; p < 0.001). Temporal reliability was also tested, showing a test–retest ICC of 0.87. The mean self‐stigma score in the Spanish population was 17.68 ± 5.45 out of 32 points. Invariance across gender and age groups indicated that there are no systematic response biases by gender or age, so stratified scores could be related to other constructs.

Significance

The Spanish version of ESSS (ESSS‐S) is a valid and reliable tool for the assessment of self‐stigma in PWE among Spanish speakers.

Plain Language Summary

This study aimed to validate the Epilepsy Self‐Stigma Scale (ESSS) for Spanish speakers (ESSS‐S). We conducted transcultural adaptation of the scale. ESSS‐S showed high reliability and strong validity, correlating with higher anxiety and depression, lower self‐esteem, and quality of life. ESSS‐S is a reliable and valid tool for assessing self‐stigma in Spanish‐speaking people with epilepsy.
Functional analysis of antigen presentation by enteric glial cells during intestinal inflammation
Authors: Brown Ryan M. , Le Helen H. , Babcock Isaac W. , Harris Tajie H. , Gaultier Alban
Published: November 2024

The Enteric Nervous System is composed of a vastly interconnected network of neurons and glial cells that coordinate to regulate homeostatic gut function including intestinal motility, nutrient sensing, and mucosal barrier immunity. Enteric Glial Cells (EGCs) are a heterogeneous cell population located throughout the gastrointestinal tract and have well described roles in regulating intestinal immune responses. Enteric Glial Cells have been suggested to act as nonconventional antigen presenting cells via the Major Histocompatibility Complex II (MHC II), though this has not been confirmed functionally. Here, we investigate the capability of EGCs to present antigen on MHC I and MHC II using in vitro antigen presentation assays performed with primary murine EGC cultures. We found that EGCs are capable of functional antigen presentation on MHC I, including antigen cross‐presentation, but are not capable of functional antigen presentation on MHC II. We also determined EGC cell surface MHC I and MHC II expression levels by flow cytometry during intestinal inflammation during Dextran Sodium Sulfate‐induced colitis or acute Toxoplasma gondii infection. We found that EGCs upregulate MHC I during acute T. gondii infection and induce low‐level MHC II expression. These findings suggest that EGCs may be important in the regulation of CD8+ T cell responses via MHC I mediated antigen (cross) presentation but may not be relevant for MHC II‐mediated antigen presentation.
Preventive Human Genome Editing and Enhancement: Candidate Criteria for Governance
Authors: Juengst Eric , Flatt Michael A. , Conley John M. , Davis Arlene , Henderson Gail , MacKay Douglas , Major Rami , Walker Rebecca L. , Cadigan R. Jean
Published: November 2024

While somatic cell editing to treat disease is widely accepted, the use of human genome editing for “enhancement” remains contested. Scientists and policy‐makers routinely cite the prospect of enhancement as a salient ethical challenge for human genome editing research. If preventive genome editing projects are perceived as pursuing human enhancement, they could face heightened barriers to scientific, public, and regulatory approval. This article outlines what we call “preventive strengthening research” (or “PSR”) to explore, through this example, how working to strengthen individuals’ resistance to disease beyond what biomedicine considers to be the human functional range may be interpreted as pursuing human enhancement. Those involved in developing guidance for PSR will need to navigate the interface between preventive goals and enhancement implications. This article identifies and critiques three of these ideas in the interest of anticipating the wider emergence of PSR and the need for a normative approach for its pursuit. All three “candidate criteria” merit attention, but each also faces challenges that will need to be addressed as further research policy is developed.
Why Aren't There More Whistleblowers?
Authors: Aronowitz Robert A.
Published: November 2024

In The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No, bioethicist Carl Elliot seeks to understand people who blow the whistle on unethical human research projects. The book compares whistleblowers in six scandals, and Elliot's main explanation for why someone becomes a whistleblower is personal honor. Exploring what led to or might have prevented these scandals, Elliot is critical of institutional review boards, and he links research ethics violations to injustices in everyday clinical care and medical training and to power imbalances in medical institutions. Some of the clinical and scientific details in the cases suggest other moral and ethical problems and the increasing irrelevance of the practice‐research distinction. Whistleblowers are also needed for the mass experiments that occur when practices diffuse without robust evidence and for the structural inequalities on which American clinical care, teaching, and research depend.
Johan C. Bester replies:
Authors: Bester Johan C.
Published: November 2024

This letter responds to a letter by Moti Gorin in the same issue, September‐October 2024, of the Hastings Center Report.
Stef M. Shuster and Meredithe McNamara reply:
Authors: Shuster Stef M. , McNamara Meredithe
Published: November 2024

This letter responds to a letter by Moti Gorin in the same issue, September‐October 2024, of the Hastings Center Report.
Impact of Transoral Robotic Surgery Versus Radiation on Swallowing Function in Oropharyngeal Cancer Patients: A Sub‐Study From a Randomized Trial
Authors: Theurer Julie. A. , Martino Rosemary , Jovanovic Nedeljko , de Almeida John R. , Goldstein David P. , Fung Kevin , Yoo John , MacNeil S. Danielle , Winquist Eric , Hammond J. Alex , Venkatesan Varagur , Read Nancy , Kuruvilla Sarah , Warner Andrew , Doyle Philip C. , Ross Ian , Dreyer Colleen , Hawkins Sarah , Thouless Kendra , McCallum Courtney , Palma David A. , Nichols Anthony C.
Published: November 2024

Background

This ORATOR sub‐study evaluated swallowing physiology in patients treated with transoral robotic surgery (TORS) versus radiotherapy (RT) for early‐stage oropharynx cancer.

Methods

Swallowing physiology was evaluated using videofluoroscopy and outcomes were compared across treatment arms and correlated with MDADI scores.

Results

Of the 68 patients in the ORATOR trial, 21 participated in this sub‐study (30.8%), including 15 RT Arm and six TORS Arm patients. Swallowing profiles were not significantly different between the arms. MBSImP pharyngeal scores for RT Arm versus TORS Arm patients were 4.8 (±2.1) versus 4.3 (±1.5) at baseline, 6.2 (±1.2) versus 9.6 (±4.8) at 6 months and 5.9 (±1.8) versus 8.0 (±4.7) at 12 months. MBSImP pharyngeal scores demonstrated weak associations with several MDADI subscales and PAS scores.

Conclusions

To best describe swallowing outcomes in studies of RT and/or surgery, instrumental swallowing assessments should be strongly considered in addition to quality of life measures.
E. coli‐Assisted Eco‐Friendly Production of Biogenic Silver Cobalt Oxide (AgCoO2) Nanoparticles: Methanolysis‐Based Hydrogen Production, Wastewater Remediation, and Pathogen Control
Authors: Irshad Aisha , Mahmood Sajid , Fazal Tanzeela , Iqbal Shahid , Rehman Mujaddad‐ur‐ , Zidan Ammar , Shah Mazloom , Bahadur Ali , Hayat Azam , Khan Asma , Malik Attiya Abdul , Awwad Nasser S. , Ibrahium Hala A.
Published: November 2024

Herein, bacterial‐assisted synthesis of AgCoO2 is carried out. In the first step, E. coli was separated from soil samples via the “serial dilution method.” Ten milliliters of bacterial supernatant was mixed with cobalt chloride and silver nitrate hatched at 38°C for 24 h to get AgCoO2 nanoparticles (NPs). XRD results confirm the synthesis of AgCoO2 NPs while EDX results confirm the absence of any other elements than Ag, Co, and O. An average NP size of 12‐26 nm was determined by TEM examination, and the surface of the particles was seen rough, irregularly shaped borders. The antibacterial activity of the constructed NPs was checked against S. aureus, E. coli, Bacillus subtilus, and Pseudomanas areguinosa using agar well diffusion method. The maximum zone of inhibition was 27 mm at 40 mg/mL against Bacillus subtilus. The performance of the synthesized NPs as photocatalysts was also assessed, and several operational parameters that control the photodegradation of the harmful dyes were tried to tune as well, and 85% degrading efficiency was obtained at 60oC for 240 min for 30 mg of catalyst dose These NPs were also used to produce hydrogen by methanolysis.
Pneumonia in patients with chronic lymphocytic leukemia treated with venetoclax‐based regimens: A real‐world analysis of Polish Adult Leukemia Group (PALG)
Authors: Kalicińska Elżbieta , Jablonowska‐Babij Paula , Morawska Marta , Iskierka‐Jażdżewska Elżbieta , Drozd‐Sokolowska Joanna , Paszkiewicz‐Kozik Ewa , Szukalski Łukasz , Strzała Judyta , Gosik Urszula , Dębski Jakub , Andrasiak Iga , Skotny Anna , Jamroziak Krzysztof , Wrobel Tomasz
Published: November 2024

Background

Patients with chronic lymphocytic leukemia (CLL) are susceptible to infections that can affect their clinical outcomes.

Aims

To assess: (1) the incidence of pneumonia in CLL patients treated with venetoclax‐based regimens in a real‐world setting, (2) the risk factors for event‐free survival (EFS), and (3) overall survival (OS).

Methods

This multicenter study included 322 patients from eight centers. Univariable and multivariable analyses (MVA) were performed, having the development of pneumonia during venetoclax‐based treatment and OS as outcomes.

Results

The most common complication was neutropenia (59%). During treatment with venetoclax‐based regimens, 66 (20%) of patients developed pneumonia: 50 (23%) patients in the rituximab plus venetoclax (R‐VEN) group, 13 (16%) patients in the obinutuzumab plus venetoclax (O‐VEN) group (p = 0.15). Chronic obstructive pulmonary disease (COPD)/asthma, splenomegaly, elevated creatinine, and anemia <8 g/dL were the risk factors for EFS in MVA (hazard ratio [HR] = 2.08, 95% confidence interval [CI], 1.16–3.74, p = 0.014; HR 1.73, 95% CI, 1.08–2.78, p = 0.02; HR 2.13, 95% CI, 1.10–4.11, p = 0.03, HR 3.58, 95% CI, 2.18–5.89, p < 0.001, respectively). Relapsed/refractory (R/R) CLL patients treated with R‐VEN with pneumonia had worse OS than those without (p < 0.001). In patients treated with O‐VEN, median OS did not differ between patients with and without pneumonia (p = 0.45).

Conclusions

Our real‐world study showed that pneumonia during venetoclax treatment occurs more frequently than reported in registration trials and has a negative impact on OS, especially in patients with R/R CLL treated with R‐VEN. Neutropenia is not a risk factor for pneumonia.
Comparative Evaluation of Niño1+2 and Niño3.4 Indices in Terms of ENSO Effects Over the Euro‐Mediterranean Region
Authors: Yavuzsoy‐Keven Ece , Ezber Yasemin , Sen Omer Lutfi
Published: November 2024

Global or regional impacts of El Niño Southern Oscillation (ENSO) have predominantly been investigated through the Niño3.4 index, representing the sea surface temperature (SST) variations in the central Tropical Pacific. In this study, we comparatively evaluated the usefulness of Niño1+2, a relatively less utilised index that represents SST variability in the Eastern Tropical Pacific. In our analyses, we focused on ENSO impacts on Euro‐Mediterranean (EM) climate variability during boreal winter, using data from the NCEP/NCAR Reanalysis. The correlation analysis involving Niño1+2 depicts more distinct temperature and precipitation patterns over the EM region. Amongst the SST‐based Niño indices, it has the highest correlation with the East Atlantic index (0.47, statistically significant at > 99% confidence level), a prominent regional teleconnection associated primarily with the strength of the East Atlantic ridge, which produces dipole‐type climate patterns between East Atlantic/Western Europe and Central/Eastern Mediterranean. Moreover, its lagged correlations with the following spring (0.39), summer (0.31), and autumn (0.36) are all statistically significant at ≥ 99% confidence levels. The composite analysis shows that different Niño regions have distinct effects on atmospheric circulation and climate in the EM region. The Niño1+2 index is particularly helpful in identifying the years when warm SST anomalies of El Niño extend to the Eastern Equatorial Pacific, which results in a reversal of temperatures across the EM region. Thus, this study suggests that Niño1+2 is a useful index for studying climate variability and predictability in the EM region, especially when used in conjunction with other Niño indices, as it captures some ENSO features that they may not encompass.
Diverging Projections of Future Droughts in High‐End Climate Scenarios for Different Potential Evapotranspiration Methods: A National‐Scale Assessment for Poland
Authors: Marcinkowski Paweł , Eini Mohammad Reza , Venegas‐Cordero Nelson , Jefimow Maciej , Piniewski Mikołaj
Published: November 2024

It has been broadly reported that future climate change will most likely affect the spatio‐temporal distribution of water resources and consequently droughts. There is a prevailing notion that an increase in temperature and frequency of heat waves are expected to result in more intense droughts in the coming years. In this study, we aimed to evaluate the effect of the potential evapotranspiration (PET) method selection on future drought projections over Poland. In our study, simulations of the Soil and Water Assessment Tool (SWAT) model were conducted, utilising an ensemble of six EURO‐CORDEX projections, spanning the period from 2006 to 2100 under the RCP8.5 scenario. Two model setups with two different PET methods (Penman‐Monteith—PM and Hargreaves—HAR) were used. For drought conditions evaluation we selected the Standardized Precipitation Index (SPI) and Standardized Precipitation‐Evapotranspiration Index (SPEI) for meteorological drought, Standardized Streamflow Index (SSI) for hydrological drought, and Standardized Soil Moisture Index (SMI) for agricultural drought. The meteorological and hydrological droughts were calculated using a 12‐month time aggregation window, while agricultural drought was calculated using a 3‐month window. Climate projections revealed that by 2080s annual mean temperature and precipitation increase is expected by up to +3.4°C and +10.3% respectively. Under future climate conditions duration and severity of meteorological droughts are projected to decrease. PM method leads to a higher PET increases (1.35 mm year−1) than the HAR method (1.1 mm year−1) throughout the century which entail diverging signal of change for agricultural and hydrological droughts. PM‐ and HAR‐based simulations indicate increase in the total duration and cumulative severity of agricultural droughts, buthowever, for HAR‐based projections, the increase is much less. For hydrological droughts the signal of change is similar for both PET methods, but considerably distinct in magnitude. Considering the entire simulation period, by the end of the century cumulative severity of hydrological droughts is projected to decrease, with a much more pronounced decline for HAR (70% reduction) than for the PM method (35% reduction). Our study demonstrated that methodological choices are crucial to the assessment of future drought risk under climate change.
Matrikine stimulation of equine synovial fibroblasts and chondrocytes results in an in vitro osteoarthritis phenotype
Authors: Gagliardi Rachel , Koch Drew W. , Loeser Richard , Schnabel Lauren V.
Published: November 2024

Osteoarthritis (OA) is a debilitating disease that impacts millions of individuals and has limited therapeutic options. A significant hindrance to therapeutic discovery is the lack of in vitro OA models that translate reliably to in vivo preclinical animal models. An alternative to traditional inflammatory cytokine models is the matrikine stimulation model, in which fragments of matrix proteins naturally found in OA tissues and synovial fluid, are used to stimulate cells of the joint. The objective of this study was to determine if matrikine stimulation of equine synovial fibroblasts and chondrocytes with fibronectin fragments (FN7‐10) would result in an OA phenotype. We hypothesized that FN7‐10 stimulation of equine articular cells would result in an OA phenotype with gene and protein expression changes similar to those previously described for human chondrocytes stimulated with FN7‐10. Synovial fibroblasts and chondrocytes isolated from four horses were stimulated in monolayer culture for 6 or 18 h with 1 µM purified recombinant 42 kD FN7‐10 in serum‐free media. At the conclusion of stimulation, RNA was collected for targeted gene expression analysis and media for targeted protein production analysis. Consistent with our hypothesis, FN7‐10 stimulation resulted in significant alterations to many important genes that are involved in OA pathogenesis including increased expression of IL‐1β, IL‐4, IL‐6, CCL2/MCP‐1, CCL5/RANTES, CXCL6/GCP‐2, MMP‐1, MMP‐3, and MMP13. The results of this study suggest that the equine matrikine stimulation model of OA may prove useful for in vitro experiments leading up to preclinical trials.