bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of pandemic‐related experiences and maternal psychological distress in maternal rejection
Authors: İplikçi Ayşe Büşra , İlgün Yağmur , Memisoglu‐Sanli Aybegüm , Aydoğdu Sözen Ezgi , Sahin‐Acar Basak , Doğan Aysun , Tahiroglu Deniz , Berument Sibel Kazak
Published: December 2023

Objective

The current study focuses on the indirect link between mothers' COVID‐19 pandemic‐related experiences of home chaos, pandemic‐related anxiety, social support, and perceived maternal rejection through maternal psychological distress (MPD).

Background

The COVID‐19 pandemic had striking effects on families, and parents with school‐aged children were especially considered more at risk. Yet, the growing research documented negative and positive outcomes for the parent–child relationship.

Method

In this two‐wave study, data were collected before (January–February 2020) and during the pandemic (November–December 2020) from 318 Turkish mothers (Mage = 37.13, SD = 5.67) with predominantly low educational attainment and children in Grades 1 to 11 (Mage = 11.57, SD = 3.05). MPD and perceived maternal rejection were measured before and during the pandemic. Maternal pandemic‐related anxiety, mothers' perceived social support, and chaos in the home environment were measured only during the pandemic. Structural equation modeling was used for analysis.

Results

After pre‐pandemic MPD and perceived maternal rejection were controlled, MPD was positively associated with rejection during the pandemic. Pandemic‐related anxiety and home chaos, but not social support, predicted maternal rejection through MPD.

Conclusion

Mothers' COVID‐19–related experiences were related to increased MPD, which also predicted increased maternal rejection as perceived by children.

Implications

The results should be considered in developing programs for mothers facing stressful circumstances. In particular, we recommend programs that promote equal role division in the family, which could support maternal well‐being, alleviate MPD, and improve the mother–child relationship.
Mutations at proximal cysteine residues in PML impair ATO binding by destabilizing the RBCC domain
Authors: Dubey Suchita , Mishra Neha , Shelke Rohan , Varma Ashok K.
Published: December 2023

Acute promyelocytic leukemia (APL) is characterized by the fusion gene promyelocytic leukemia–retinoic acid receptor‐alpha (PML–RARA) and is conventionally treated with arsenic trioxide (ATO). ATO binds directly to the RING finger, B‐box, coiled‐coil (RBCC) domain of PML and initiates degradation of the fusion oncoprotein PML–RARA. However, the mutational hotspot at C212–S220 disrupts ATO binding, leading to drug resistance in APL. Therefore, structural consequences of these point mutations in PML that remain uncertain require comprehensive analysis. In this study, we investigated the structure‐based ensemble properties of the promyelocytic leukemia‐RING‐B‐box‐coiled‐coil (PML‐RBCC) domains and ATO‐resistant mutations. Oligomeric studies reveal that PML‐RBCC wild‐type and mutants C212R, S214L, A216T, L217F, and S220G predominantly form tetramers, whereas mutants C213R, A216V, L218P, and D219H tend to form dimers. The stability of the dimeric mutants was lower, exhibiting a melting temperature (Tm) reduction of 30 °C compared with the tetrameric mutants and wild‐type PML protein. Furthermore, the exposed surface of the C213R mutation rendered it more prone to protease digestion than that of the C212R mutation. The spectroscopic analysis highlighted ATO‐induced structural alterations in S214L, A216V, and D219H mutants, in contrast to C213R, L217F, and L218P mutations. Moreover, the computational analysis revealed that the ATO‐resistant mutations C213R, A216V, L217F, and L218P caused changes in the size, shape, and flexibility of the PML‐RBCC wild‐type protein. The mutations C213R, A216V, L217F, and L218P destabilize the wild‐type protein structure due to the adaptation of distinct conformational changes. In addition, these mutations disrupt several hydrogen bonds, including interactions involving C212, C213, and C215, which are essential for ATO binding. The local and global structural features induced by these mutations provide mechanistic insight into ATO resistance and APL pathogenesis.
Soil organic carbon loss decreases biodiversity but stimulates multitrophic interactions that promote belowground metabolism
Authors: Li Ye , Chen Zengming , Wagg Cameron , Castellano Michael J. , Zhang Nan , Ding Weixin
Published: December 2023

Soil organic carbon (SOC) plays an essential role in mediating community structure and metabolic activities of belowground biota. Unraveling the evolution of belowground communities and their feedback mechanisms on SOC dynamics helps embed the ecology of soil microbiome into carbon cycling, which serves to improve biodiversity conservation and carbon management strategy under global change. Here, croplands with a SOC gradient were used to understand how belowground metabolisms and SOC decomposition were linked to the diversity, composition, and co‐occurrence networks of belowground communities encompassing archaea, bacteria, fungi, protists, and invertebrates. As SOC decreased, the diversity of prokaryotes and eukaryotes also decreased, but their network complexity showed contrasting patterns: prokaryotes increased due to intensified niche overlap, while that of eukaryotes decreased possibly because of greater dispersal limitation owing to the breakdown of macroaggregates. Despite the decrease in biodiversity and SOC stocks, the belowground metabolic capacity was enhanced as indicated by increased enzyme activity and decreased enzymatic stoichiometric imbalance. This could, in turn, expedite carbon loss through respiration, particularly in the slow‐cycling pool. The enhanced belowground metabolic capacity was dominantly driven by greater multitrophic network complexity and particularly negative (competitive and predator–prey) associations, which fostered the stability of the belowground metacommunity. Interestingly, soil abiotic conditions including pH, aeration, and nutrient stocks, exhibited a less significant role. Overall, this study reveals a greater need for soil C resources across multitrophic levels to maintain metabolic functionality as declining SOC results in biodiversity loss. Our researchers highlight the importance of integrating belowground biological processes into models of SOC turnover, to improve agroecosystem functioning and carbon management in face of intensifying anthropogenic land‐use and climate change.
Care as infrastructure: Rethinking working mothers' childcare crisis during the COVID‐19 pandemic
Authors: Li Meng , Laughlin Corrina
Published: December 2023

During the COVID‐19 pandemic, the United States government promoted the idea of care as infrastructure to justify government spending on nonphysical infrastructures. In this article, we demonstrate the usefulness of adopting an infrastructure framework for researching care and caring through an analysis of working mothers' communication on Reddit in the early days of the COVID‐19 pandemic. Employing infrastructural inversion as a heuristic, we conceptualize the childcare crisis experienced by working mothers in many Western societies as an infrastructural disruption in which the cascading failure of childcare infrastructures exposed the background work of care as well as its vulnerability and invisibility. We also argue that, against this backdrop, an alternate infrastructure of digital caring emerged. However, this informal infrastructure was inadequate to sustain the needs of working mothers, and its emergence, in itself, provides proof of the need to value care as infrastructure. Ultimately, we showcase how conceptualizing care as infrastructure can enrich feminist theorization of care, and that centering care as infrastructure redresses the bias toward physical infrastructure in the scholarly literature.
Prognostic significance of C‐reactive protein in unresectable hepatocellular carcinoma treated with atezolizumab and bevacizumab
Authors: Kaneko Shun , Asahina Yasuhiro , Murakawa Miyako , Ueyama Shunsuke , Maeyashiki Chiaki , Watanabe Hideki , Kusano‐Kitazume Akiko , Sato Ayako , Uchidate Kozue , Asakawa Takehito , Watanabe Sho , Iizuka Yasuhiro , Shibata Isamu , Oooka Shinya , Karakama Yuko , Fujii Takashi , Watabe Taro , Akahoshi Keiichi , Tanabe Minoru , Inada Kento , Mochida Tomohiro , Watakabe Keiya , Shimizu Taro , Tsuchiya Jun , Miyoshi Masato , Kitahata‐Kawai Fukiko , Nitta Sayuri , Nakagawa Mina , Kakinuma Sei , Okamoto Ryuichi ,   Ochanomizu Liver Conference Study Group
Published: December 2023

Aim

C‐reactive protein (CRP) is both an inflammatory and prognostic marker in various cancers. This study aimed to elucidate the characteristics of CRP and the prognostic factors in patients who were administered with atezolizumab plus bevacizumab (ATZ + BEV) for unresectable hepatocellular carcinoma (HCC).

Methods

A total of 213 patients who received ATZ + BEV for HCC from November 2020 to March 2023 at 15 hospitals were enrolled in this retrospective study. The prognosis was analyzed by subdividing the patients based on baseline characteristics, radiologic response, and treatment lines. Accuracy of survival prediction was assessed using CRP, alpha fetoprotein (AFP), C‐reactive protein and alpha fetoprotein in immunotherapy (CRAFITY), and Glasgow Prognostic Score.

Results

Compared with patients with baseline CRP <1 mg/dL, those with baseline CRP ≥1 mg/dL (n = 45) had a significantly higher baseline albumin–bilirubin score and AFP levels, significantly lower disease control rate (62.2%), and significantly shorter median overall survival (hazards ratios 2.292; 95% confidence interval 1.313–5.107; log‐rank test, p < 0.001). Multivariate analysis identified CRP ≥1 mg/dL, AFP ≥100 ng/mL, and modified albumin–bilirubin grade as the significant prognostic factors. The baseline CRP, AFP, CRAFITY, and Glasgow Prognostic Score demonstrated higher discrimination for 1‐year survival prediction after first‐line ATZ + BEV administration, compared with beyond second line, with area under the receiver operating characteristic curves of 0.759, 0.761, 0.805, and 0.717, respectively.

Conclusions

CRP was a significant biomarker in patients treated with ATZ + BEV for HCC. Elevated CRP levels may indicate aggressive cancer progression and potential resistance to ATZ + BEV therapy.
Knowledge‐based representation: Patient engagement in drug development
Authors: Egher Claudia , Zvonareva Olga
Published: December 2023

Introduction

Recently, different actors have intensified their efforts to make drug development more participatory. They have produced many frameworks, tools and dedicated fora, where patients are portrayed as relevant stakeholders to be involved throughout the entire drug development trajectory. To better understand what such participatory efforts entail, in this article, we investigate how patient representation is configured in drug development and what patients can engage as representatives in this field.

Methods

This is a qualitative study based on the thematic analysis of 40 semistructured interviews with different stakeholders in the field and three patient engagement How‐To guides (HTGs) complemented by observations of two sessions of the Patient Engagement Open Forum (PEOF) and a patient expert training of the European Patients' Academy on Therapeutic Innovation (EUPATI).

Findings

The emerging practices of patient engagement in drug development configure representation as hinging upon three types of knowledge—drug development knowledge, autobiographical knowledge and community knowledge—and a specific set of skills. We discern a new kind of representation based on these findings, termed ‘knowledge‐based representation’, which appears to more accurately describe how patients are expected to represent others in drug development.

Conclusion

Even though knowledge‐based representation may be understood as an attempt to downplay the political aspects of representation in favour of its epistemic elements, the political processes involved in patient representation in drug development cannot be ignored. The extent to which reliance on knowledge‐based representation will contribute to democratic decision‐making is likely to depend on the resources needed to develop the types of knowledge relevant to representation work and on how these types of knowledge are determined.

Patient or Public Contribution

Patient representatives and practitioners in the field of patient engagement (including 13 interviewees, representatives of EUPATI and HTG developers) gave feedback on the interpretation of the findings during a multistakeholder workshop we organised. We also sent an interviewee an extended draft and discussed it during an online meeting. Claudia Egher presented these findings at a PEOF session in June 2023, which further contributed to their validation.
Comprehensive evaluation of ocular complications in atopic dermatitis: insights from a contemporary cohort study in Korean population
Authors: Seo Yuri , Han Jinu , Kim Min J. , Cha Nu‐Ree , Kim Jihee
Published: December 2023

Background

Atopic dermatitis (AD) is a chronic inflammatory skin disorder associated with various systemic and ocular complications. This study aimed to investigate the prevalence, risk factors, and clinical characteristics of ocular complications in a cohort of Korean AD patients.

Methods

A retrospective review of medical records was conducted for AD patients who visited the dermatology and ophthalmology clinics at the same institution. Demographic data, clinical characteristics, and types of ocular complications were recorded. Logistic regression analysis was performed to identify factors associated with ocular complications.

Results

A total of 212 AD patients were included in the study. The intraocular complications had a prevalence of 1.9%, whereas ocular surface diseases were observed more frequently, with prevalence of 13.2%. Among the ocular complications, blepharitis was the most prevalent, followed by atopic keratoconjunctivitis. Subcapsular cataract, atrophic hole, and retinal detachment were also observed. The head and neck score in the Eczema Area and Severity Index (EASI) emerged as a significant predictor for intraocular complications, independent of age, gender, total EASI score, and family history. No significant association was found between total EASI score and ocular surface disease.

Conclusion

This study provides insights into the prevalence and risk factors of ocular complications in Korean AD patients. The head and neck score in EASI was identified as a significant predictor for intraocular complications. These findings emphasize the importance of comprehensive evaluation and interdisciplinary care for AD patients, particularly in identifying and managing potential vision‐threatening complications.
Qualitative systematic review: The lived experiences of males in the nursing profession on gender discrimination encounters
Authors: Ng Matthew , See Celine , Ignacio Jeanette
Published: December 2023

Aims

This review aims to synthesise the best available evidence exploring the lived experiences of males in the nursing profession on gender discrimination encounters.

Background

The underrepresentation of males within the nursing profession could potentially cause discrimination and stereotypes against them, causing barriers to entry into, and retention within, the profession. With a shortage in manpower, the deterrence of males to nursing might exacerbate the existing manpower shortage. This review consolidates and highlights the lived experiences of males in the profession.

Methods

The review was synthesised according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) checklist. Employing the meta‐synthesis approach, two independent reviewers conducted critical appraisal and data extraction of included studies, using the standard Joanna Briggs Institute (JBI) Critical Appraisal Instrument for Qualitative Research and a standardised data extraction form, respectively.

Results

Twenty‐three studies were included. Extracted findings were aggregated into 14 categories and synthesised into three themes: stereotypes, discrimination and challenges faced by males.

Discussion

The synthesised findings showed that male nurses faced gender discrimination in multiple facets. These caused them to have difficulty in carrying out their nursing duties, missing out of clinical opportunities and causing them multiple social and mental stressors.

Conclusion

This review informed the discriminatory experiences faced by males within the nursing profession. With males already underrepresented within this profession, it is imperative for interventions, policies and research to be made to address this issue to improve experiences of male nurses, thereby limiting the deterrence of males into the profession.

Implications

Findings of this study showed that males are being stereotyped and discriminated, resulting in challenges faced solely because of their gender. Effective interventions and policies could be implemented to alleviate the negative experiences.
On the Most Effective Use of Continuous Auxiliary Variables in Regression Estimation in Survey Sampling
Authors: Merkouris Takis
Published: December 2023

Auxiliary variables with known population totals are extensively used in survey sampling to construct generalised regression (GR) estimators or optimal regression (OR) estimators of totals or means of study variables. This article explores the possibility of improving the efficiency of such estimators when continuous auxiliary variables are used in the regression estimation jointly with appropriate power functions of them, provided that the values of the auxiliary variables are known for all units in the population. The efficiency gain is determined analytically in the case of the OR estimator. A practical criterion for choosing the power functions that maximise the efficiency gain, involving the coefficient of determination in the regression fit of the study variable, is proposed for both the OR estimation and the more practicable, but generally less efficient, GR estimation. Furthermore, the effect of adding a power function of a continuous auxiliary variable in regression estimation is investigated when this variable is also used at the design stage. A simulation study shows that the joint use of a continuous auxiliary variable and a power function of it chosen according to the proposed criterion may improve considerably the efficiency of OR estimation, and much more the efficiency of GR estimation.
The role of the clinical nurse specialist in stoma care: A modified Delphi consensus
Authors: Burch Jennie , Bird Andrew , Thorpe Gabrielle
Published: December 2023

Introduction

The role of the clinical nurse specialist is complex but is defined differently across the world. The role of clinical nurse specialist stoma care is undefined and it is uncertain what aspects of the role are included in the general day‐to‐day working role.

Aims

The aim was to gain consensus opinion to answer the research question: ‘What is the role of the clinical nurse specialist in stoma care?’

Design

Delphi consensus.

Methods

Previous data gained from a scoping review and expert consultation was utilized to form role statements. At a UK conference the 13 statements and 173 sub‐categories were voted upon. Consensus was agreed if 75% of voters voted agree or strongly agree. Two stages of voting occurred with results from the first vote being shared in the second voting session.

Results

All 13 statement and most (150/193) statement sub‐categories reached consensus, with 20 sub‐categories added during voting session one.

Conclusions

The four pillars of advanced practice were met by the 13 statements with clinical and education reaching higher consensus and agreement than leadership/management and research. The results of the consensus study provide a clearer articulation of the clinical nurse specialist stoma care role, which is complex and multifaceted which has not been described previously.

Implications for Practice

Consideration of role evolution is made possible, to gain a greater expertise in the scope of practice it is necessary to include prescribing, management and research which could improve service delivery and optimize patient outcomes. There was no patient or public contribution, which in hindsight would have potentially improved the process but it was considered that patients might not recognize the full role of the nurse, understanding only aspects of the role that were patient‐centred.

Patient or Public Contribution

No patients or public were involved in any aspect of this paper—in hindsight this might have been useful.
Unravelling the cavity‐nesting network at large spatial scales: The biogeographic role of woodpeckers as ecosystem engineers
Authors: Alaniz Alberto J. , Carvajal Mario A. , Quiroz Madelaine , Vergara Pablo M. , Marquet Pablo A. , Fierro Andrés , Sieving Kathryn E. , Moreira‐Arce Darío , Hidalgo‐Corrotea Claudia , Rodríguez‐San Pedro Annia , Allendes Luis , Machuca Katerine
Published: December 2023

Aim

Primary cavity nesters (e.g. woodpeckers) act as ecosystem engineers by providing tree cavities to several vertebrates that use them as nests or refuges. Although diverse assemblages of primary excavators are assumed to increase the number of tree cavities, environmental factors can limit populations of primary excavators, thus weakening their ecological function. We aim to test the biogeographical‐scale relationships between primary excavators and cavity users by distinguishing the contribution of environmental variables.

Location

Southern South America.

Materials and Methods

We used species distribution models, which combine bioclimatic and remote sensing derived variables, to map the richness of vertebrates composing the cavity‐network of temperate and Mediterranean forests of South America. Based on a resampling procedure for ensuring spatial independence, we fitted structural equation models to estimate relationships between forest characteristics and cavity user vertebrates.

Results

Richness of secondary cavity users (mammals, obligated, habitat generalists and forest specialists) were positively and strongly influenced by the richness of primary excavators. Environmental variables affected differently the richness of primary and secondary cavity users. The richness of primary cavity users responded to tree richness and height while that of habitat specialist secondary users was positively affected by primary productivity and negatively by sclerophyll forests.

Main Conclusions

Our results confirm the role of primary excavators as ecosystem engineers but highlight the importance of considering large spatial scales when analysing cavity‐nesting networks. Biogeographical patterns of tree diversity and forest structure can be important drivers of cavity nesting networks that remain hidden when studies are conducted over fine spatial scales.
Low‐dose aspirin for prevention of cardiovascular mortality in patients with type 2 diabetes and chronic kidney disease: A real‐world nationwide cohort study
Authors: Lin Yi‐Cheng , Chen Bi‐Li , Chen Wan‐Ting , Chien Li‐Nien , Huang Chun‐Yao
Published: December 2023

Aims/Introduction

Cardiovascular mortality risk is elevated among patients with diabetes and concurrent chronic kidney disease. However, controversy surrounds the use of aspirin for primary prevention within this population. This study aims to assess the effectiveness and safety of low‐dose aspirin for primary prevention in patients with diabetes and pre‐end‐stage renal disease.

Materials and Methods

This was a retrospective population‐based cohort study using the National Health Insurance Research Database in Taiwan. The study included adults with type 2 diabetes who were enrolled in the pre‐end‐stage renal disease pay‐for‐performance program and had no atherosclerotic cardiovascular disease. We used propensity score analysis to control baseline characteristics between the two groups. Clinical outcomes including cardiovascular mortality, all‐cause mortality, major bleeding, and renal disease progression were compared between patients who first received aspirin and those who did not.

Results

Between January 2012 and December 2015, a total of 2,155 low‐dose aspirin users and 6,737 nonaspirin users were identified. Following propensity score adjustment, aspirin use exhibited a comparable risk of cardiovascular death compared with nonaspirin users (adjusted hazard ratio [aHR] 1.12; 95% confidence interval [CI] 0.65–1.95; P = 0.681). The risk of all‐cause mortality was similar between the two groups (aHR 1.07; 95% CI 0.92–1.24; P = 0.385). Similar risks were observed in terms of major bleeding and renal disease progression.

Conclusions

In patients with diabetes and pre‐end‐stage renal disease who lacked atherosclerotic cardiovascular disease, low‐dose aspirin did not demonstrate a reduction in mortality. These findings do not support the use of aspirin for primary prevention in this high‐risk population.
TOPK promotes the development of psoriasis and worenine alleviates psoriasiform dermatitis by inhibiting TOPK activity
Authors: Lu Hui , Huang Yingze , Ni Xiaofang , Ma Tengfei , Chang Teding , Liu Man , Li Nijie , Lu Peijiang , Yuan Ping , Liu Lin , Shi Fei , Xiao Juanjuan , Xiao Han , Duan Qiuhong , Zhu Feng
Published: December 2023

Background

Psoriasis is an inflammatory skin disease. The pathogenesis of psoriasis has not been fully elucidated. T‐lymphokine‐activated killer cell‐originated protein kinase (TOPK) activity increases in a proinflammatory environment, and inhibiting TOPK blocks inflammation. However, whether TOPK is involved in the pathogenesis of psoriasis remains to be identified.

Objectives

We aimed to study the role of TOPK in psoriasis and attempted to find a drug targeting TOPK for the prevention and treatment of psoriasis.

Method

Firstly, the expressions of TOPK in psoriatic patients, psoriatic cell and animal model were analysed by Gene Expression Omnibus database, immunohistochemistry (IHC) staining and western blot (WB). After inhibiting TOPK by chemical or gene knockout, the effect of TOPK on the development of psoriasis was verified in cell and animal model by WB, qRT‐PCR, ELISA, haematoxylin–eosin (H&E) and IHC staining. Moreover, phosphoproteomic analysis was performed to explore the signalling pathways regulated by TOPK in the occurrence and development of psoriasis. Then, an in vitro kinase assay was performed to prove TOPK kinase activity was inhibited by worenine. Ultimately, WB, qRT‐PCR, ELISA, H&E and IHC staining were used to verify the anti‐psoriasis effect of worenine by inhibiting TOPK was in cell and animal model.

Results

In this study, we found that TOPK was highly expressed in psoriasis patients, psoriatic cell and animal model, which suggests that TOPK might be associated with psoriasis pathogenesis. Interestingly, chemical or genetic inhibition of TOPK alleviated M5‐ and imiquimod (IMQ)‐induced psoriasis‐like dermatitis, which further confirmed the role of TOPK in promoting the development of psoriasis. Moreover, we determined that worenine inhibited TOPK kinase activity. In addition, worenine relieved M5‐ and IMQ‐induced psoriasiform dermatitis by inhibiting TOPK activity.

Conclusions

T‐lymphokine‐activated killer cell‐originated protein kinase promotes the development of psoriasis. Therefore, TOPK might be a promising drug target for the prevention and treatment of psoriasis. Worenine alleviates psoriasiform dermatitis by inhibiting TOPK activity, providing new strategies for clinical intervention.
Understanding the anatomy of dermoscopy of melanocytic skin tumours: Correlation in vivo with line‐field optical coherence tomography
Authors: Soglia S. , Pérez‐Anker J. , Albero R. , Alós L. , Berot V. , Castillo P. , Cinotti E. , Del Marmol V. , Fakih A. , García A. , Lenoir C. , Monnier J. , Perrot J. L. , Puig S. , Rubegni P. , Skowron F. , Suppa M. , Tognetti L. , Venturini M. , Malvehy J.
Published: December 2023

Background

Early melanoma detection is the main factor affecting prognosis and survival. For that reason, non‐invasive technologies have been developed to provide a more accurate diagnosis. Recently, line‐field confocal optical coherence tomography (LC‐OCT) was developed to provide an in vivo, imaging device, with deep penetration and cellular resolution in three dimensions. Combining the advantages of conventional OCT and reflectance confocal microscopy, this tool seems to be particularly suitable for melanocytic lesions.

Objectives

The objective of this study was to identify and describe the correlation between specific dermoscopic criteria and LC‐OCT features in three dimensions associated with melanocytic lesions.

Methods

Dermoscopic and LC‐OCT images of 126 melanocytic lesions were acquired in three different centres. The following dermoscopic criteria have been considered: reticular pattern, dots and globules, structureless areas, blue‐whitish veil, regression structures, negative network, homogeneous pattern, streaks and blotches.

Results

69 (55%) benign and 57 (45%) malignant lesions were analysed. A regular reticular pattern was found associated in the 75% of the cases with the presence of elongated rete ridges with pigmented cells along the basal layer, while atypical reticular pattern showed an irregular organization of rete ridges with melanocytic hyperplasia, broadened and fused ridges and elongated nests. Both typical and atypical dots and globules were found associated with melanocytic nests in the dermis or at the dermoepidermal junction (DEJ), as well as with keratin cysts/pseudocysts. Grey globules corresponded to the presence of melanin‐containing dermal inflammatory cells (melanophages) within the papillae. Structureless brown/black areas correlated with alterations of the DEJ. We observed the same DEJ alterations, but with the presence of dermal melanophages, in 36% of the cases of blue/white/grey structureless areas. A description of each LC‐OCT/dermoscopy correlation was made.

Conclusions

LC‐OCT permitted for the first time to perform an in vivo, 3D correlation between dermoscopic criteria and pathological‐like features of melanocytic lesions.
Simulation and experimental study on the effect of deformation on heat and mass transfer in potato chips during superheated steam drying
Authors: Fu Hanyu , Zheng Zhaohui , Ren Liuyang , Yang Pei , Xu Jingshen , Xie Weijun , Yang Deyong
Published: December 2023

Superheated steam drying is a drying technology with enormous potential and numerous advantages. Volume change and substantial deformation will occur on the materials to be dried during the superheated steam drying, which would affect the heat and mass transfer of the sample. However, the influence mechanism is not clear. Therefore, the nonuniform volume change of potato slices was studied, and the deformation model (DM) and the non‐DM (NDM) were constructed and verified to study the heat and mass transfer processes of the sample. The results showed that there was little difference between the measured and simulated temperatures based on DM and NDM with a maximum error of 4.22% and 5.03%, respectively, but there was obvious difference between simulated moisture contents with a maximum error of 5.76% and 12.21%, respectively. The volume in DM was in good agreement with the experimental data. Temperature distribution and moisture distribution in potato chips during superheated steam drying were nonuniform and the maximum temperature gradient and moisture gradient appeared in the early period. The moisture gradient existed in the whole drying process, and the stress caused by the moisture gradient was the main factor causing the drying deformation.

Practical applications

This work can reveal that the volume change and substantial deformation have a significant impact on the heat and mass transfer during drying. In production practice, there are many similar phenomena. The results would be helpful to understand the heat and mass transfer mechanism, optimize quality parameters to obtain better products in potato drying industry, and expand the applied range of the superheated steam drying technology.
Breeding maize of ideal plant architecture for high‐density planting tolerance through modulating shade avoidance response and beyond
Authors: Jafari Fereshteh , Wang Baobao , Wang Haiyang , Zou Junjie
Published: December 2023

Maize is a major staple crop widely used as food, animal feed, and raw materials in industrial production. High‐density planting is a major factor contributing to the continuous increase of maize yield. However, high planting density usually triggers a shade avoidance response and causes increased plant height and ear height, resulting in lodging and yield loss. Reduced plant height and ear height, more erect leaf angle, reduced tassel branch number, earlier flowering, and strong root system architecture are five key morphological traits required for maize adaption to high‐density planting. In this review, we summarize recent advances in deciphering the genetic and molecular mechanisms of maize involved in response to high‐density planting. We also discuss some strategies for breeding advanced maize cultivars with superior performance under high‐density planting conditions.
Molecular evolution of the rbcS multiple gene family in Oryza punctata
Authors: Xu Si , Meng Lu , Bao Ying
Published: December 2023

Rubisco is assembled from large subunits (encoded by chloroplast gene rbcL) and small subunits (encoded by the nuclear rbcS multigene family), which are involved in the processes of carbon dioxide fixation in the Calvin cycle of photosynthesis. Although Rubisco has been studied in many plants, the evolutionary divergences among the different rbcS genes are still largely unknown. Here, using a rice closely related wild species, Oryza punctata Kotschy ex Steud, we investigated the differential properties of the rbcS genes in the species. We identified five rbcS genes (OprbcS1 through OprbcS5), OprbcS1 showed a different evolutionary pattern from the remaining four genes in terms of chromosome location, gene structure, and sequence homology. Phylogenetic analysis revealed that plant rbcS1 and other non‐rbcS1 genes originated from a common ancient duplication event that occurred at least in seed plants ancestor. RbcS1 was then retained in a few plant lineages, including Oryza, whereas non‐rbcS1 was mainly amplified in angiosperms. OprbcS1, OprbcS2–OprbcS4, and OprbcS5 were prominently expressed in stems and seeds, young leaves, and mature leaves, respectively. The yeast two‐hybrid assay detected a significant decrease in the interaction between OprbcS1 and OprbcL compared to the other four pairs of proteins (OprbcS2–OprbcS5 and OprbcL). We propose that OprbcS1 might be assigned a divergent function that was predominantly specific to nonphotosynthetic organs, whereas OprbcS2–OprbcS5, having different affinity in the assembly process of Rubisco, might be subfunctionalized in photosynthetic organs. This study not only deepens our understanding of the fine assembly of Rubisco, but also sheds some light on future de novo domestication of wild rice.
Social cognition and the origin of concepts in Durkheim's sociology of knowledge
Authors: D. Walsh Philip
Published: December 2023

This paper re‐examines a key feature of Emile Durkheim's sociology of knowledge from a critical realist perspective. It is argued that Durkheim's attempt to establish a social basis for the categories in The Elementary Forms of Religious Life should be understood along ontological rather than epistemological lines. This brings to light new problems with the argument which, however, can be brought fruitfully into contact with the more recent social psychological literature on collective intentionality. This yields insights into future lines of inquiry into social cognition and theories of human conceptualizing capacities.
Machine‐learning model comprising five clinical indices and liver stiffness measurement can accurately identify MASLD‐related liver fibrosis
Authors: Fan Rong , Yu Ning , Li Guanlin , Arshad Tamoore , Liu Wen‐Yue , Wong Grace Lai‐Hung , Liang Xieer , Chen Yongpeng , Jin Xiao‐Zhi , Leung Howard Ho‐Wai , Chen Jinjun , Wang Xiao‐Dong , Yip Terry Cheuk‐Fung , Sanyal Arun J. , Sun Jian , Wong Vincent Wai‐Sun , Zheng Ming‐Hua , Hou Jinlin
Published: December 2023

Background & Aims

aMAP score, as a hepatocellular carcinoma risk score, is proven to be associated with the degree of chronic hepatitis B‐related liver fibrosis. We aimed to evaluate the ability of aMAP score for metabolic dysfunction‐associated steatotic liver disease (MASLD; formerly NAFLD)‐related fibrosis diagnosis and establish a machine‐learning (ML) model to improve the diagnostic performance.

Methods

A total of 946 biopsy‐proved MASLD patients from China and the United States were included in the analysis. The aMAP score, demographic/clinical indices and liver stiffness measurement (LSM) were included in seven ML algorithms to build fibrosis diagnostic models in the training set (N = 703). The performance of ML models was evaluated in the external validation set (N = 125).

Results

The AUROCs of aMAP versus fibrosis‐4 index (FIB‐4) and aspartate aminotransferase‐platelet ratio (APRI) in cirrhosis and advanced fibrosis were (0.850 vs. 0.857 [P = 0.734], 0.735 [P = 0.001]) and (0.759 vs. 0.795 [P = 0.027], 0.709 [P = 0.049]). When using dual cut‐off values, aMAP had a smaller uncertainty area and higher accuracy (26.9%, 86.6%) than FIB‐4 (37.3%, 85.0%) and APRI (59.0%, 77.3%) in cirrhosis diagnosis. The seven ML models performed satisfactorily in most cases. In the validation set, the ML model comprising LSM and 5 indices (including age, sex, platelets, albumin and total bilirubin used in aMAP calculator), built by logistic regression algorithm (called LSM‐plus model), exhibited excellent performance. In cirrhosis and advanced fibrosis detection, the LSM‐plus model had higher accuracy (96.8%, 91.2%) than LSM alone (86.4%, 67.2%) and Agile score (76.0%, 83.2%), respectively. Additionally, the LSM‐plus model also displayed high specificity (cirrhosis: 98.3%; advanced fibrosis: 92.6%) with satisfactory AUROC (0.932, 0.875, respectively) and sensitivity (88.9%, 82.4%, respectively).

Conclusions

The aMAP score is capable of diagnosing MASLD‐related fibrosis. The LSM‐plus model could accurately identify MASLD‐related cirrhosis and advanced fibrosis.
‘The program director's word … it's stronger than the word of God’: Epistemic injustice revealed through narratives of remediated graduate medical education residents
Authors: Percival Candace S. , Maggio Lauren A. , Wyatt Tasha R. , Martin Paolo C.
Published: December 2023

Background

Though graduate medical education (GME) residency training provides positive experiences for many trainees, it may also result in major stressors and negative experiences, particularly for those requiring remediation. Residents requiring remediation may experience feelings of dismay, shame and guilt that can negatively affect their training, self‐efficacy and their medical careers. Power differentials between educators and residents may set the stage for epistemic injustice, which is injustice resulting from the silencing or dismissing a speaker based on identity prejudice. This can lead to decreased willingness of trainees to engage with learning. There is a paucity of literature that explores GME experiences of remediation from the resident perspective.

Objective

To synthesise the narratives of physician experiences of remediation during residency through the lens of epistemic injustice.

Methods

Between January and July 2022, we interviewed US physicians who self‐identified as having experienced remediation during residency. They shared events that led to remediation, personal perspectives and emotions about the process and resulting outcomes. Interviews were analysed using narrative analysis with attention to instances of epistemic injustice.

Results

We interviewed 10 participants from diverse backgrounds, specialties and institutions. All participants described contextual factors that likely contributed to their remediation: (1) previous academic difficulty/nontraditional path into medicine, (2) medical disability or (3) minoritised race, gender or sexual identity. Participants felt that these backgrounds made them more vulnerable in their programmes despite attempts to express their needs. Participants reported instances of deflated credibility and epistemic injustices with important effects.

Conclusions

Participant narratives highlighted that deep power and epistemic imbalances between learners and educators can imperil GME trainees' psychological safety, resulting in instances of professional and personal harm. Our study suggests applying an existing framework to help programme directors (PDs) approach remediation with epistemic humility.
Structure–function relationships underpin disulfide loop cleavage‐dependent activation of Legionella pneumophila lysophospholipase A PlaA
Authors: Hiller Miriam , Diwo Maurice , Wamp Sabrina , Gutsmann Thomas , Lang Christina , Blankenfeldt Wulf , Flieger Antje
Published: December 2023

Legionella pneumophila, the causative agent of a life‐threatening pneumonia, intracellularly replicates in a specialized compartment in lung macrophages, the Legionella‐containing vacuole (LCV). Secreted proteins of the pathogen govern important steps in the intracellular life cycle including bacterial egress. Among these is the type II secreted PlaA which, together with PlaC and PlaD, belongs to the GDSL phospholipase family found in L. pneumophila. PlaA shows lysophospholipase A (LPLA) activity which increases after secretion and subsequent processing by the zinc metalloproteinase ProA within a disulfide loop. Activity of PlaA contributes to the destabilization of the LCV in the absence of the type IVB‐secreted effector SdhA. We here present the 3D structure of PlaA which shows a typical α/β‐hydrolase fold and reveals that the uncleaved disulfide loop forms a lid structure covering the catalytic triad S30/D278/H282. This leads to reduction of substrate access before activation; however, the catalytic site gets more accessible when the disulfide loop is processed. After structural modeling, a similar activation process is suggested for the GDSL hydrolase PlaC, but not for PlaD. Furthermore, the size of the PlaA substrate‐binding site indicated preference toward phospholipids comprising ~16 carbon fatty acid residues which was verified by lipid hydrolysis, suggesting a molecular ruler mechanism. Indeed, mutational analysis changed the substrate profile with respect to fatty acid chain length. In conclusion, our analysis revealed the structural basis for the regulated activation and substrate preference of PlaA.
Efficacy of biofilm disrupters against Candida auris and other Candida species in monomicrobial and polymicrobial biofilms
Authors: Cox Claudia A. , Manavathu Elias K. , Wakade Sushama , Myntti Matthew , Vazquez Jose A.
Published: December 2023

Candida species are now considered global threats by the CDC and WHO. Candida auris specifically is on the critical pathogen threat list along with Candida albicans. In addition, it is not uncommon to find Candida spp. in a mixed culture with bacterial organisms, especially Staphylococcus aureus producing polymicrobial infections. To eradicate these organisms from the environment and from patient surfaces, surface agents such as chlorhexidine (CHD) and Puracyn are used. Biofilm disrupters (BDs) are novel agents with a broad spectrum of antimicrobial activity and have been used in the management of chronic wounds and to sterilise environmental surfaces for the past several years. The goal of this study was to evaluate BDs (BlastX, Torrent, NSSD) and CHD against Candida spp. and S. aureus using zone of inhibition assays, biofilm and time‐kill assays. All BDs and CHD inhibited C. auris growth effectively in a concentration‐dependent manner. Additionally, CHD and the BDs showed excellent antimicrobial activity within polymicrobial biofilms. A comparative analysis of the BDs and CHD against C. auris and C. albicans using biofilm kill‐curves showed at least 99.999% killing. All three BDs and CHD have excellent activity against different Candida species, including C. auris. However, one isolate of C. auris in a polymicrobial biofilm assay showed resistance/tolerance to CHD, but not to the BDs. The fungicidal activity of these novel agents will be valuable in eradicating surface colonisation of Candida spp, especially C. auris from colonised environmental surfaces and from wounds in colonised patients.
A missed opportunity for health promotion? Perceptions of large‐scale housing developments in Aotearoa New Zealand
Authors: Schindler Mirjam
Published: December 2023

Large‐scale housing developments (LHD) are increasingly being used to accommodate population growth in (sub)urban Aotearoa, but their market‐oriented and delivery‐focused approach raises questions about whether resulting housing supplies meet residents' expectations for a healthy living environment. Based on a mixed‐methods survey with expert and non‐expert residents in the Wellington Region, this research critically examines LHD and underscores the pressing need for a stronger emphasis on health promotion in rapidly growing (sub)urban environments. The study reveals a strong desire among study participants for more social infrastructure in LHD and greater responsibility on the part of LHD developers towards communal values and community engagement.
Features, management, and outcomes of pediatric scalp melanomas
Authors: Mologousis Mia A. , Moustafa Danna , Hawryluk Elena B.
Published: December 2023

Pediatric melanoma of the scalp has the highest mortality of any anatomic location. We describe five pediatric patients with a diagnosis of scalp melanoma receiving care at Massachusetts General Hospital and/or Boston Children's Hospital from 2018 through 2022. Melanoma presented in diverse contexts: cellular blue nevus‐associated, compound nevus‐associated, spitzoid, nodular, and superficial spreading subtypes. This study describes a range of melanoma presentations and emphasizes the need for additional compilation of data on pediatric scalp melanomas to promote their recognition and improve patient care.
Divergent effects of warming on nonstructural carbohydrates in woody plants: a meta‐analysis
Authors: He Rui , Shi Hang , Hu Man , Zhou Quan , Zhang Quanfa , Dang Haishan
Published: December 2023

Nonstructural carbohydrates (NSC, including soluble sugars and starch) are essential for supporting growth and survival of woody plants, and play multifunctional roles in various ecophysiological processes that are being rapidly changed by climate warming. However, it still remains unclear whether there is a consistent response pattern of NSC dynamics in woody plants to climate warming across organ types and species taxa.

Here, based on a compiled database of 52 woody plant species worldwide, we conducted a meta‐analysis to investigate the effects of experimental warming on NSC dynamics.

Our results indicated that the responses of NSC dynamics to warming were primarily driven by the fluctuations of starch, while soluble sugars did not undergo significant changes. The effects of warming on NSC shifted from negative to positive with the extension of warming duration, while the negative warming effects on NSC became more pronounced as warming magnitude increased.

Overall, our study showed the divergent responses of NSC and its components in different organs of woody plants to experimental warming, suggesting a potentially changed carbon (C) balance in woody plants in future global warming. Thus, our findings highlight that predicting future changes in plant functions and terrestrial C cycle requires a mechanism understanding of how NSC is linked to a specific global change driver.