bluuebunny/crossref_metadata_2025 huggingface dataset:
“Those are the Spaces Where I Feel Seen and Fully Understood”: Digital Counterspaces Fostering Community, Resistance, and Intersectional Identities Among Latinx LGBTQ+ Emerging Adults
Authors: Lopez-Leon Gloriana , Casanova Saskias
Published: April 2023

For Latinx LGBTQ+ emerging adults, forming a positive social identity involves intersectionally navigating ethnoracial prejudice and heterosexism. Social media contexts are essential for minoritized emerging adults to access information and social support and explore their identities. Our research examines how these contexts serve as counterspaces that promote positive identity development, where minoritized people resist marginalizing narratives and collectively reimagine their intersectional selves. Our qualitative case study spotlights how a self-identified gender fluid, assigned female at birth, bisexual Latinx emerging adult at a public university, used digital counterspaces to resist intersectional marginality and construct positive social identities. After conducting inductive and deductive thematic analyses of two semi-structured interviews, we identified three themes (1) Intersectional Discrimination, experiences related to gendered colorism and gendered heterosexism; (2) Identity Work Through Narratives, resistance through the use of online spaces to develop critical consciousness, and counternarratives; and (3) Intersectional Counterspaces, the development of a coherent sense of self through digital spaces that validate and affirm intersectional identities. Our study expands how researchers imagine counterspaces and provides recommendations for practitioners to increase their understanding of Latinx LGBTQ+ emerging adults’ social media use.
Dynamic Prediction of Patient Outcomes in the Intensive Care Unit: A Scoping Review of the State-of-the-Art
Authors: Lapp Linda , Roper Marc , Kavanagh Kimberley , Bouamrane Matt-Mouley , Schraag Stefan
Published: April 2023

Introduction

Intensive care units (ICUs) are high-pressure, complex, technology-intensive medical environments where patient physiological data are generated continuously. Due to the complexity of interpreting multiple signals at speed, there are substantial opportunities and significant potential benefits in providing ICU staff with additional decision support and predictive modeling tools that can support and aid decision-making in real-time. This scoping review aims to synthesize the state-of-the-art dynamic prediction models of patient outcomes developed for use in the ICU. We define “dynamic” models as those where predictions are regularly computed and updated over time in response to updated physiological signals.

Methods

Studies describing the development of predictive models for use in the ICU were searched, using PubMed. The studies were screened as per Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and the data regarding predicted outcomes, methods used to develop the predictive models, preprocessing the data and dealing with missing values, and performance measures were extracted and analyzed.

Results

A total of n = 36 studies were included for synthesis in our review. The included studies focused on the prediction of various outcomes, including mortality (n = 17), sepsis-related complications (n = 12), cardiovascular complications (n = 5), and other complications (respiratory, renal complications, and bleeding, n = 5). The most common classification methods include logistic regression, random forest, support vector machine, and neural networks.

Conclusion

The included studies demonstrated that there is a strong interest in developing dynamic prediction models for various ICU patient outcomes. Most models reported focus on mortality. As such, the development of further models focusing on a range of other serious and well-defined complications—such as acute kidney injury—would be beneficial. Furthermore, studies should improve the reporting of key aspects of model development challenges.
Test methodology for validating tractor structural part under multiaxial loading
Authors: Chakraborty Abhirup , Arunachalam Kandavel
Published: April 2023

A tractor is a machine which is predominantly used for various agricultural operations such as plowing, tilling, planting, harvesting, etc. Apart from the regular agricultural applications, currently, tractor is being also used for various other applications such as haulage, dozing, loading, digging, and so on. Because of the versatility in usage patterns and applications, it is extremely difficult to estimate the loads coming on different structural parts of a tractor. Therefore, fatigue behaviors of different structural parts are also highly unpredictable. Limited test methodologies or information are available about the testing methodologies to validate the structural parts of a tractor. Conventional uniaxial load tests may not be sufficient to replicate actual Real World Usage Pattern (RWUP) as different structural failures are reported from field testing or end customers despite clearing in different lab testing. On the other hand, multiaxial loading may produce more realistic and accurate test results. In this paper, an attempt has been made to develop a practically deployable and simple to use laboratory test methodology considering multiaxial loading to validate Rear Axle Carrier (RAC) assembly of a tractor. At the end of the study, simple to put methodology has been demonstrated in which all the stated objectives were full filled. Real time acquired load data have been used to analyze and develop the duty cycle with a considerable test time reduction in place. This methodology can be used for validating similar kind of structures.
Contact stress analysis of external non-variable multi-modulus spur gear pairs
Authors: Zhu Zengbao , Cui Hongbo , Gong Mingzhen , Bao Heyun , Zhu Rupeng
Published: April 2023

The conditions of correct gear engagement of a pair of involute gears and the principle of geometric relationship of involute tooth profile are derived to determine the pitch point of externally meshing non-variable multi-modulus spur gear pairs into the double tooth engagement region. The Hertzian contact stress model is used as the basis to derive the contact stress calculation equations for pitch point and other characteristic contact points, and the variation of the contact stress distribution on the contact line with the module ratio is analyzed. The results demonstrate that when the number of teeth of the gear pairs is determined, the larger the value of the module difference, the easier it is for the pitch point of the gear pairs to be in the double tooth meshing zone. Except for the double tooth meshing out point, the contact stress decreases with the increase of module ratio, and the maximum point of contact stress is at the upper boundary point of the single tooth meshing zone.
‘Stuck in the System’: An Interpretative Phenomenological Analysis of Transmasculine Experiences of Gender Transition in the UK
Authors: Mills Tyler J. , Riddell Kirstie E. , Price Elizabeth , Smith David R. R.
Published: April 2023

A gender dysphoria diagnosis is currently required in the UK to access NHS transition-related treatment. However, this approach has been criticised by academics and activists as pathologising, ‘gatekeeping’ transgender identities, and can be viewed by the transgender community as a barrier to necessary medical care. The present research examines transmasculine experiences of gender transition in the UK, focusing on exploring the barriers encountered during identity development and medical transition. Semi-structured interviews were conducted with three individuals, and nine individuals took part in a single focus group. The data were analysed using Interpretative Phenomenological Analysis producing three main themes: ‘Conceptualising Stages of Transition’; ‘NHS Communication and Support’; and ‘Medicalisation, Power and Non-disclosure’. Participants conceptualised access to transition-related treatment as an intrusive and complicated process that negatively impacts identity development. They spoke of barriers such as lack of trans-specific healthcare knowledge, insufficient communication and support from healthcare professionals, and restricted autonomy arising from the pathologisation of trans identities. Results suggest transmasculine individuals may face numerous barriers when trying to access healthcare, and therefore, a move towards the Informed Consent Model could ameliorate many of these barriers and would empower service-users to make informed choices.
Alar Asymmetry in Patients with Unilateral Cleft Lip: Implications for Secondary Rhinoplasty
Authors: Harrison Lucas M. , Kenyon Laura , Mathew Denzil P. , Derderian Christopher A. , Hallac Rami R.
Published: April 2023

Objective

Alar asymmetry in unilateral cleft lip (UCL) nasal deformity is a well-recognized clinical feature. However, there is a lack of comprehensive quantitative analysis of this asymmetry. This study compares the shape, volume, and axis rotation between the cleft and non-cleft ala in skeletally mature patients with UCL.

Design

A retrospective comparative study utilizing three-dimensional rendered CT scans.

Setting

Tertiary care pediatric institution.

Patients, Participants

This study included 18 patients with UCL nasal deformity at skeletal maturity.

Main Outcome Measure(s)

Cleft and non-cleft side ala volume, surface area, and axis to the midsagittal plane.

Results

The cleft-side ala was significantly lesser in volume by 27.3%, significantly lesser in surface area by 17.6%, and significantly greater in surface area to volume ratio by 14.6% than the non-cleft ala. The cleft-side ala was significantly greater by 43.1% horizontal axis to the midsagittal plane. In patients with primary rhinoplasty, the cleft-side ala had 28.0% less volume and 18.7% less surface area. In intermediate rhinoplasty, the cleft-side ala had 39.1% less volume and 23.5% less surface area than the non-cleft ala.

Conclusions

Significant asymmetry exists between the cleft-side and non-cleft ala in patients with UCL. The cleft-side ala is significantly smaller in volume and surface area than the non-cleft ala. Additionally, the cleft-side ala demonstrates a significantly greater horizontal axis that contributes considerably to nasal asymmetry, supporting the need to restore a normal vertical axis to the clef-side ala.
Examining the Influence of Physician Assistant/Associate Scope of Practice Reforms and Individual Characteristics on Wages
Authors: White Ryan D.
Published: April 2023

High labor demand for physician assistants/associates (PA) has led to substantial PA workforce and wage growth. During this growth period, states have adopted reforms to reduce PA scope of practice restrictions and reports of significant gender and race wage disparities have emerged. This study examined data from the American Community Survey to investigate the influence of demographic characteristics, human capital, and scope of practice reforms on PA wages from 2008 to 2017. Using an ordinary least squares two-way fixed effects estimator, a significant association between reforms and PA wages could not be established. Rather, wages were found to be strongly associated with human capital and demographic characteristics. Gender and race wage disparities persist, with female PAs earning 7.5% lower wages than male PAs and White PAs earning 9.1% to 14.5% higher wages than racial and ethnic minority PAs. These findings suggest a minimal influence of prior scope of practice reforms on PA wages.
‘Show Us a Kiss!’: The Everyday Sexual Harassment Experiences of Female Lesbian, Bisexual, and Queer Students
Authors: Witcomb Gemma L. , Cooper Charlotte
Published: April 2023

This study explored the experiences of lesbian, bisexual, and queer (LBQ) students’ ( N = 9, aged 19–24) of sexual harassment via semistructured interviews. Data were analysed using a thematic analysis. Three overarching themes emerged: (a) the paradox of men's unwanted sexual attention, (b) the negative impact on relationships, and (c) the LGBTQ* community as a refuge. The women reported enduring unwanted heteronormative sexual attention, and heterosexist and homophobic harassment which forced some to conceal their sexuality. Support for the LGBTQ* community was central in developing confidence to call-out harassment. The findings call for the inclusion of LBQ-specific messages in sexual violence awareness and prevention interventions.
Incarcerated Young Men, Masculinity, and Trauma
Authors: Cesaroni Carla , Maycock Matthew , Vaswani Nina
Published: April 2023

The current article is part of a unique comparative study of the experiences and adjustment of 190 incarcerated young men in both Scotland and Canada. In collecting data on the participants’ lives, the authors learned of the multiple traumas and losses many of them had suffered. Many participants however seemed to adhere to a prison masculinity that may constrain help-seeking behavior. Ultimately, this article analyses the levels of trauma that exists in a population of incarcerated young men within the context and alongside of the masculine ideals they appeared to adhere to. This article advocates for gender-responsive trauma-informed care for incarcerated young men that incorporates an exploration and understanding of masculine identity and how it interacts with help-seeking and trauma recovery.
artbin: Extended sample size for randomized trials with binary outcomes
Authors: Marley-Zagar Ella , White Ian R. , Royston Patrick , Barthel Friederike M.-S. , Parmar Mahesh K. B. , Babiker Abdel G.
Published: April 2023

We describe the command artbin, which offers various new facilities for the calculation of sample size for binary outcome variables that are not otherwise available in Stata. While artbin has been available since 2004, it has not been previously described in the Stata Journal. artbin has been recently updated to include new options for different statistical tests, methods and study designs, improved syntax, and better handling of noninferiority trials. In this article, we describe the updated version of artbin and detail the various formulas used within artbin in different settings.
robustpf: A command for robust estimation of production functions
Authors: Hu Yingyao , Huang Guofang , Sasaki Yuya
Published: April 2023

We introduce a new command, robustpf, to estimate parameters of Cobb–Douglas production functions. The command is robust against two potential problems. First, it is robust against optimization errors in firms’ input choice, unobserved idiosyncratic cost shocks, and measurement errors in proxy variables. In particular, the command relaxes the conventional assumption of scalar unobservables. Second, it is also robust against the functional dependence problem of static input choice, which is known today as a cause of identification failure. The main method is proposed by Hu, Huang, and Sasaki (2020, Journal of Econometrics 215: 375–398).
acreg: Arbitrary correlation regression
Authors: Colella Fabrizio , Lalive Rafael , Sakalli Seyhun Orcan , Thoenig Mathias
Published: April 2023

We present acreg, a new command that implements the arbitrary clustering correction of standard errors proposed in Colella et al. (2019, IZA discussion paper 12584). Arbitrary here refers to the way observational units are correlated with each other: we impose no restrictions so that our approach can be used with a wide range of data. The command accommodates both cross-sectional and panel databases and allows the estimation of ordinary least-squares and two-stage least-squares coefficients, correcting standard errors in three environments: in a spatial setting using units’ coordinates or distance between units, in a network setting starting from the adjacency matrix, and in a multiway clustering framework taking multiple clustering variables as input. Distance and time cutoffs can be specified by the user, and linear decays in time and space are also optional.
How family physicians introduce palliative care to patients with chronic illnesses
Authors: Slobogian Vanessa , Vig Chandra , Shirt Lisa , Shuman Chelsey , Sondermann Margot , Vanderveen Monique , Bouchal Shelley Raffin
Published: April 2023

Objective

Increasing numbers of Canadians living with complex, life-limiting conditions demand high-quality palliative care. Timely access to palliative care can help to reduce stress, improve quality of life, and provide relief for patients and their families. The purpose of this study is to explore the experiences of family physicians (FPs) regarding the decision and process of introducing palliative care to patients with chronic diseases.

Methods

Interpretive description methodology was used to guide the investigation of the research question. Thirteen Calgary Zone FPs participated in individual interviews. Data was collected iteratively and analyzed using constant comparative analysis.

Results

Analysis of interviews identified the overarching themes of dignity and empowerment, which describe the experience of FPs introducing palliative care to chronically ill patients. Four subthemes were woven throughout, including the art of conversation, therapeutic relationships, timing, and preparation of the patient and family.

Discussion

While the benefits of palliative conversations are widely accepted, a deeper understanding of how FPs can be supported in developing this aspect of their practice is needed. Understanding their experience provides knowledge that can serve as a framework for future education, mentorship, and competency development.
Coupled hygrothermal and mechanical simulations of highly anisotropic building material during freezing and thawing
Authors: Fukui Kazuma , Iba Chiemi , Ogura Daisuke
Published: April 2023

Porous building materials, such as board materials, wood, stones, fired clay materials, and bio-based materials, often have anisotropic properties. This study investigates adequate numerical models for the coupled hygrothermal and mechanical behaviors of strongly anisotropic building materials during freezing and thawing. First, strain measurements are reported for two types of fired clay materials to confirm the anisotropy of deformation during freezing and thawing. In calculations, the anisotropy of the Biot coefficient of a material is considered based on anisotropic poroelasticity. The comparison between the measurements and calculations revealed that the anisotropic deformation during the measurement cannot be reproduced without considering the anisotropies of the Biot coefficient as well as those of the mechanical properties. In addition, analysis of the causes of the deformation reveals that the expansion in the direction normal to the material thickness due to the water pressure development during the freezing is suppressed by the small Biot coefficient. These results indicate that the anisotropy of the Biot coefficient significantly influence the deformation due to frost actions; consequently, the anisotropic Biot coefficient should be adequately considered in numerical simulations.
Towards a model that measures the impact of disinformation on elections
Authors: Syrovátka Jonáš , Hořejš Nikola , Komasová Sarah
Published: April 2023

Disinformation represents a danger to the integrity and legitimacy of the electoral process. From our research based on the 2021 Czech parliamentary elections, we introduce a model for measuring the resilience of citizens to disinformation. This model is then used to draw conclusions about the impact of disinformation on their voting behaviour. We argue that it is important to understand this impact in the context of pre-existing beliefs and opinions, and therefore in terms of disinformation reinforcing rather than changing existing views. In particular, we demonstrate how feeling disappointed with one political party can make people more inclined to endorse disinformation that targets it.
Status-Based Asymmetries in Relative Deprivation During the COVID-19 Pandemic
Authors: Lilly Kieren J. , Sibley Chris G. , Osborne Danny
Published: April 2023

The COVID-19 pandemic has amplified existing inequalities by disproportionately affecting marginalized groups, which should differentially affect perceptions of, and responses to, inequality. Accordingly, the present study examines the effects of the pandemic on feelings of individual- and group-based relative deprivation (IRD and GRD, respectively), as well as whether these effects differ by ethnicity. By comparing matched samples of participants assessed before and during the first 6 months of the pandemic ( Ntotal = 21,131), our results demonstrate the unique impacts of the pandemic on IRD and GRD among ethnic minorities and majorities. Moreover, our results reveal the status-based indirect effects of the pandemic on support for both collective action and income redistribution via IRD and GRD. As the pandemic rages on, these results foreshadow long-term, status-specific consequences for political mobilization and support for social change.
Early Baby Bathing Practice and its Associated Factors Among Mothers who Give Birth in the Past One Month in Gurage Zone, Ethiopia, 2022
Authors: Beyene Derribow Aberash , Demissie Mebratu , Abebe Seboka , Obsa Megertu , Endeshaw Fikremariam , Asnake Haregwa , Yosef Yirgalem , Taddese Betelhem
Published: April 2023

Background

Ethiopia has still suffered the highest burden of neonatal morbidity and mortality. The World Health Organization's practical guide for the thermal protection of newborns recommends delaying the bathing of newborns for at least 24 h following delivery, as it is crucial to prevent neonatal mortality and morbidity and to achieve 2030 sustainable development goals. However, little is known about delayed newborn bathing practices in Ethiopia. Therefore, the purpose of this study was to assess early baby bathing practices and associated factors among postpartum women.

Methods

A mixed community-based cross-sectional study was conducted among a total of 582 postnatal mothers. A multistage sampling technique was used to select study participants. A pre-tested and structured questionnaire was used to collect data. The data was entered into Epi-Data version 4.2.0 and exported into SPSS version 23 for analysis. Three focus group discussions with postnatal mothers were used for qualitative data. A purposive sampling method was used. Thematic analysis was used for qualitative data. Bivariate and multivariate logistic regression analyses were used in the analysis. To declare statistically significant, p-values of .05 were used.

Result

This study revealed that 250 (43%) mothers were practicing early newborn bathing. Early baby bathing was associated with antenatal care (ANC) follow-up (AOR  =  5.1  =  .95% CI  =  (2.6–9.9)), having no recent complications during birth (AOR  =  1.9  =  95% CI  =  (1.02–3.6), having information about the time of baby bathing (AOR  =  6.02, 95% CI  =  (3.9, 9.3)), knowledge of hypothermia (AOR  =  3.3  =  95.6% CI (1.9–5.8), and poor knowledge about neonatal danger signs.

Conclusion and Recommendation

ANC follow-up, recent complications during birth, having information, knowledge about hypothermia, and neonatal danger signs were significantly associated with early baby bathing. Continuous health education on the appropriate time of baby bathing and neonatal danger signs and enhanced ANC service utilization are recommended.
Assessing the Ethical Concerns of Medical Students in the Gross Anatomy Lab
Authors: Nawras Mohamad , Aoun Jihad , Yazdi Vahid , Hecht Mordechai , Khuder Sadik , Frank Patrick
Published: April 2023

OBJECTIVES

Cadaver dissection has become the gold-standard for anatomical education in US medical schools. Ethical issues regarding cadavers may not be as obvious as in living patients, which can lead to their potential neglect in medical school curricula. In this study, we assessed the different ethical concerns (ECs) of medical students regarding cadavers in the gross anatomy lab (GAL), gathered student information, including self-reported academic performance (AP) in the GAL, and determined the best predictors for a student's EC.

METHODS

All second-year medical students at the University of Toledo were invited to complete an anonymous, online-survey. Participants were presented with 10 hypothetical but realistic lab scenarios and asked to rate their EC for each on a 5-point Likert scale. Gender, age, and scores received in the GAL course were also collected. A multiple linear regression model was used to find the best predictors of the total EC score.

RESULTS

A total of 112 (63%) responses to the online-survey were recorded. The highest EC was for Q7: Taking pictures of the cadaver. The lowest EC was for Q10: The dissection of cadavers itself is an EC. Gender was the best predictor of total EC, followed by age. Female total EC was significantly higher than that for males (35.8 ± 5.5 vs 33.1 ± 7.9). Female scores for Q1 and Q2 were significantly higher than those for males. Total EC for students in the age group 25 to 34 was significantly higher than those in the age group 18 to 24 (35.9 ± 6.1 vs 33.9 ± 7.2). No significant difference was found for individual scenarios. AP was not significantly related to the total score or the scores of the individual scenarios.

CONCLUSION

The significant differences in ECs of medical students found in our study indicate that not all students have the same outlook towards the GAL specifically and ECs generally.
Evaluation of Antimalarial Activity of Ethanolic Extract of Annona muricata L.: An in vivo and an in silico Approach
Authors: Nwonuma Charles Obiora , Balogun Elizabeth Abiodun , Gyebi Gideon Ampoma
Published: April 2023

In Nigeria, Annona muricata L. has been used to treat a variety of ailments. The mechanism of the antimalarial activity of ethanolic leaf extract of Annona muricata (EEAML) was investigated using both an in vivo and an in silico approach. The experimental mice were divided into five groups: A-F. The mice in groups B-F were inoculated with Plasmodium berghei NK-65 and treated accordingly. Groups A and B are the negative and positive controls (infected and untreated), respectively. Group C received 10 mg/kg chloroquine (standard drug), whereas groups D-F received 100, 200, and 300 mg/kg body weight of the extract orally respectively. The mice were euthanized eight days after infection, and their liver and blood were collected and used in biochemical tests. Molecular docking was performed using the extract's HPLC compounds and Plasmodium falciparum proteins. In the suppressive, prophylactic, and curative tests, there was a significant decrease (p < 0.05) in parasitemia levels in groups treated with the extract compared to the positive control and standard drug. When compared to the positive control, there was a significant (p < 0.05) reduction in liver MDA, total cholesterol, and total triglyceride levels. The binding energies of luteolin and apigenin- pfprotein complexes were significantly (p < 0.05) higher compared to their respective references. The anti-plasmodial activity of the extract may result from its hypolipidemic effect, which deprives the parasite of essential lipid molecules needed for parasite growth, as well as from the inhibitory effects of apigenin and luteolin on specific proteins required for the Plasmodium metabolic pathway.
Pyloroplasty Reduces the Need for Pyloric Dilatation After Esophagectomy
Authors: Han Seunghee , Yu Choi Ling , Halle-Smith James , Dmitrewski Jan , Tan Benjamin , Siddaiah-Subramanya Manjunath
Published: April 2023

Background:

Delayed gastric conduit emptying (DGCE) is a recognized complication of esophagectomy which can lead to prolonged vomiting, aspiration, and reduced oral intake postoperatively. To minimize the risk of DGCE, some advocate the use of pyloroplasty, however the practice is varied and controversial. The aim of this study is to investigate the effect of pyloroplasty on DGCE in esophagectomy patients.

Methods:

Consecutive patients that underwent an esophagectomy for esophageal cancer from September 2011 to December 2020 were identified from a prospectively maintained departmental cancer database at our institution. The primary outcome measured was the need for pyloric intervention following esophagectomy. Secondary outcomes included cardiac complications, pulmonary complications, anastomotic leaks, and chyle leaks. For those who had contrast swallow tests done prior to discharge from the index admission, dilated conduit and delayed gastric emptying were also investigated.

Results:

Of 458 patients included in the study, 77(17%) underwent pyloroplasty. Of the 381 patients who underwent esophagectomy without pyloroplasty, 44 (12%) of these patients later required at least one pyloric dilatation. None of the patients who underwent pyloroplasty later required pyloric dilatation. On multivariate analysis, younger age, respiratory complications after esophagectomy and pyloroplasty were significant predictors of the need for pyloric dilatation. Pyloroplasty was not significantly related to dilated conduit or delayed emptying on contrast swallow with P value of 0.979 and 0.147, respectively.

Conclusions:

Pyloroplasty reduces the need for pyloric dilatation postoperatively. However, further research is required to investigate the nature of this relationship, specifically in terms of contrast swallow.
Availability and acceptability of interpreting services for refugees as a question of trauma-informed care
Authors: González Campanella Alejandra
Published: April 2023

Refugee-background communities have been a significant part of Aotearoa New Zealand’s multicultural population for decades. Despite the documented relevance of communication for newly arrived refugees, local reports over the years have found significant gaps in effective communication between culturally and linguistically diverse (CALD) populations and public service providers. This article presents findings from a study exploring interpreting in refugee contexts (IRCs) in Aotearoa New Zealand, along with the applicability and suitability of trauma-informed interpreting as a positive approach to interpreting services. Relying on interviews with refugee-background clients, the research outlined below suggests that language barriers and negative experiences when using language assistance services are often (re)settlement stressors for this population. The study further found challenges related to interpreter availability and acceptability for refugees, which were linked to client dissatisfaction and potential (re)traumatisation. The detailed discussion of findings leads to a call to embed trauma-informed principles in good practice guidelines for all professionals, including interpreters, working with potentially traumatised clients. To that end, it is imperative that interpreter education programmes provide trauma-informed training and that public service authorities ensure the use of qualified language professionals.
The tropics should not become the world's plastic pollution problem
Authors: Walker Tony R
Published: April 2023

Unsustainable plastic production, use and mismanagement have resulted in increased plastic pollution in the environment threatening sustainability, especially in the tropics. Countries in the tropics have been disproportionally impacted by plastic pollution due to imports of plastic waste from developed countries, or because tropical Small Island Developing States have become overwhelmed by single-use plastics used widely in the tourism sector. However, plastic pollution is pervasive and is not just limited to the tropics. Plastic pollution has resulted in widespread environmental, economic and social impacts globally. Most plastics are derived from fossil fuels which contribute to climate change via greenhouse gas emissions, and plastic pollution also harms wildlife threatening biodiversity, thus placing enormous pressure on earth’s limited resources. Although downstream strategies to curb plastic pollution exist, they are infective in the face of increased upstream plastic production. Therefore, the international community has recognized that a more holistic approach is required to reduce plastic pollution. Current plastic production and waste generation are still outpacing existing plastic reduction regulations. This viewpoint shows why unsustainable global plastic production has resulted in increased global plastic pollution, including in the tropics, but also highlights how ambitious plastic pollution reduction policies can help transition towards a more sustainable plastics future.
How I treat newly diagnosed and refractory T-cell acute lymphoblastic lymphoma in children and young adults
Authors: Si Lim Stephanie , Ford James B. , Hermiston Michelle L.
Published: April 2023

T-cell lymphoblastic lymphoma (T-LLy) and T-cell acute lymphoblastic leukemia (T-ALL) have historically been considered a spectrum of the same disease. However, recent evidence demonstrating differential responses to chemotherapy raise the possibility that T-LLy and T-ALL are distinct clinical and biologic entities. Here, we examine differences between the two diseases and use illustrative cases to highlight key recommendations on how to best treat newly diagnosed and relapsed/refractory T-LLy patients. We discuss results of recent clinical trials incorporating use of nelarabine and bortezomib, choice of induction steroid, role of cranial radiotherapy, and risk stratification markers to identify patients at highest risk of relapse and to further refine current treatment strategies. Because prognosis for relapsed or refractory T-LLy patients is poor, we discuss ongoing investigations incorporating novel therapies, including immunotherapeutics, into upfront and salvage regimens and the role of hematopoietic stem cell transplantation.
Noninvasive respiratory support after extubation: a systematic review and network meta-analysis
Authors: Boscolo Annalisa , Pettenuzzo Tommaso , Sella Nicolò , Zatta Matteo , Salvagno Michele , Tassone Martina , Pretto Chiara , Peralta Arianna , Muraro Luisa , Zarantonello Francesco , Bruni Andrea , Geraldini Federico , De Cassai Alessandro , Navalesi Paolo
Published: April 2023

Background

The effect of noninvasive respiratory support (NRS), including high-flow nasal oxygen, bi-level positive airway pressure and continuous positive airway pressure (noninvasive ventilation (NIV)), for preventing and treating post-extubation respiratory failure is still unclear. Our objective was to assess the effects of NRS on post-extubation respiratory failure, defined as re-intubation secondary to post-extubation respiratory failure (primary outcome). Secondary outcomes included the incidence of ventilator-associated pneumonia (VAP), discomfort, intensive care unit (ICU) and hospital mortality, ICU and hospital length of stay (LOS), and time to re-intubation. Subgroup analyses considered “prophylactic”versus“therapeutic” NRS application and subpopulations (high-risk, low-risk, post-surgical and hypoxaemic patients).

Methods

We undertook a systematic review and network meta-analysis (Research Registry: reviewregistry1435). PubMed, Embase, CENTRAL, Scopus and Web of Science were searched (from inception until 22 June 2022). Randomised controlled trials (RCTs) investigating the use of NRS after extubation in ICU adult patients were included.

Results

32 RCTs entered the quantitative analysis (5063 patients). Compared with conventional oxygen therapy, NRS overall reduced re-intubations and VAP (moderate certainty). NIV decreased hospital mortality (moderate certainty), and hospital and ICU LOS (low and very low certainty, respectively), and increased discomfort (moderate certainty). Prophylactic NRS did not prevent extubation failure in low-risk or hypoxaemic patients.

Conclusion

Prophylactic NRS may reduce the rate of post-extubation respiratory failure in ICU patients.
ICOR: improving codon optimization with recurrent neural networks
Authors: Jain Rishab , Jain Aditya , Mauro Elizabeth , LeShane Kevin , Densmore Douglas
Published: April 2023

Background

In protein sequences—as there are 61 sense codons but only 20 standard amino acids—most amino acids are encoded by more than one codon. Although such synonymous codons do not alter the encoded amino acid sequence, their selection can dramatically affect the expression of the resulting protein. Codon optimization of synthetic DNA sequences is important for heterologous expression. However, existing solutions are primarily based on choosing high-frequency codons only, neglecting the important effects of rare codons. In this paper, we propose a novel recurrent-neural-network based codon optimization tool, ICOR, that aims to learn codon usage bias on a genomic dataset of Escherichia coli. We compile a dataset of over 7,000 non-redundant, high-expression, robust genes which are used for deep learning. The model uses a bidirectional long short-term memory-based architecture, allowing for the sequential context of codon usage in genes to be learned. Our tool can predict synonymous codons for synthetic genes toward optimal expression in Escherichia coli.

Results

We demonstrate that sequential context achieved via RNN may yield codon selection that is more similar to the host genome. Based on computational metrics that predict protein expression, ICOR theoretically optimizes protein expression more than frequency-based approaches. ICOR is evaluated on 1,481 Escherichia coli genes as well as a benchmark set of 40 select DNA sequences whose heterologous expression has been previously characterized. ICOR’s performance is measured across five metrics: the Codon Adaptation Index, GC-content, negative repeat elements, negative cis-regulatory elements, and codon frequency distribution.

Conclusions

The results, based on in silico metrics, indicate that ICOR codon optimization is theoretically more effective in enhancing recombinant expression of proteins over other established codon optimization techniques. Our tool is provided as an open-source software package that includes the benchmark set of sequences used in this study.
Sulfur, sterol and trehalose metabolism in the deep-sea hydrocarbon seep tubeworm Lamellibrachia luymesi
Authors: Shi Hong , Ruan Lingwei , Chen Zimeng , Liao Yifei , Wu Wenhao , Liu Linmin , Xu Xun
Published: April 2023

Background

Lamellibrachia luymesi dominates cold sulfide-hydrocarbon seeps and is known for its ability to consume bacteria for energy. The symbiotic relationship between tubeworms and bacteria with particular adaptations to chemosynthetic environments has received attention. However, metabolic studies have primarily focused on the mechanisms and pathways of the bacterial symbionts, while studies on the animal hosts are limited.

Results

Here, we sequenced the transcriptome of L. luymesi and generated a transcriptomic database containing 79,464 transcript sequences. Based on GO and KEGG annotations, we identified transcripts related to sulfur metabolism, sterol biosynthesis, trehalose synthesis, and hydrolysis. Our in-depth analysis identified sulfation pathways in L. luymesi, and sulfate activation might be an important detoxification pathway for promoting sulfur cycling, reducing byproducts of sulfide metabolism, and converting sulfur compounds to sulfur-containing organics, which are essential for symbiotic survival. Moreover, sulfide can serve directly as a sulfur source for cysteine synthesis in L. luymesi. The existence of two pathways for cysteine synthesis might ensure its participation in the formation of proteins, heavy metal detoxification, and the sulfide-binding function of haemoglobin. Furthermore, our data suggested that cold-seep tubeworm is capable of de novo sterol biosynthesis, as well as incorporation and transformation of cycloartenol and lanosterol into unconventional sterols, and the critical enzyme involved in this process might have properties similar to those in the enzymes from plants or fungi. Finally, trehalose synthesis in L. luymesi occurs via the trehalose-6-phosphate synthase (TPS) and trehalose-6-phosphate phosphatase (TPP) pathways. The TPP gene has not been identified, whereas the TPS gene encodes a protein harbouring conserved TPS/OtsA and TPP/OtsB domains. The presence of multiple trehalases that catalyse trehalose hydrolysis could indicate the different roles of trehalase in cold-seep tubeworms.

Conclusions

We elucidated several molecular pathways of sulfate activation, cysteine and cholesterol synthesis, and trehalose metabolism. Contrary to the previous analysis, two pathways for cysteine synthesis and the cycloartenol-C-24-methyltransferase gene were identified in animals for the first time. The present study provides new insights into particular adaptations to chemosynthetic environments in L. luymesi and can serve as the basis for future molecular studies on host-symbiont interactions and biological evolution.
Comorbid psychiatric disorders and long-term survival after liver transplantation in transplant facilities with a psychiatric consultation-liaison team: a multicenter retrospective study
Authors: Kimura Hiroyuki , Kishi Shinichi , Narita Hisashi , Tanaka Teruaki , Okada Tsuyoshi , Fujisawa Daisuke , Sugita Naoko , Noma Shun’ichi , Matsumoto Yosuke , Ohashi Ayako , Mitsuyasu Hiroshi , Yoshida Keizo , Kawasaki Hiroaki , Nishimura Katsuji , Ogura Yasuhiro , Ozaki Norio
Published: April 2023

Objective

Comorbid psychiatric disorders negatively affect the survival rate of patients with some physical disorders. In liver transplant recipients, various psychiatric disorders have been identified as worsening prognosis. However, little is known about how the presence of any comorbid (overall) disorders affect the survival rate of transplant recipients. In this study, we examined the effect of overall comorbid psychiatric disorders on survival rate in liver transplant recipients.

Methods

A total of 1006 recipients who underwent liver transplantation between September 1997 and July 2017 across eight transplant facilities with a psychiatric consultation-liaison team were identified consecutively. Recipients were categorized into those with comorbid psychiatric disorders and those without comorbid psychiatric disorders. In the comorbid psychiatric disorder group, psychiatric disorder diagnosis and time of diagnosis were investigated retrospectively.

Results

Of the 1006 recipients, 294 (29.2%) had comorbid psychiatric disorders. Comorbid psychiatric disorders in the 1006 recipients were insomnia (N = 107, 10.6%), delirium (N = 103, 10.2%), major depressive disorder (N = 41, 4.1%), adjustment disorder (N = 19, 1.9%), anxiety disorder (N = 17, 1.7%), intellectual disability (N = 11, 1.1%), autism spectrum disorder (N = 7, 0.7%), somatic symptom disorder (N = 4, 0.4%) schizophrenia (N = 4, 0.4%), substance use disorder (N = 24, 2.4%) and personality disorder (N = 2, 0.2%). The most common time of psychiatric disorder diagnosis was within the first 3 months after liver transplantation (51.6%). The final mortality in patients with comorbid psychiatric disorder diagnosis during the five periods (pretransplant, transplant to 3 months, months to 1 year, 1 to 3 years, and over 3 years posttransplant) was 16.2%, 18.8%, 39.1%, 28.6%, and 16.2% respectively, and there were no significant differences between the five periods (χ2 = 8.05, df = 4, p = 0.09). Overall comorbid psychiatric disorders were significantly associated with shorter survival time (log-rank test: p = 0.01, hazard ratio: 1.59 [95% confidence interval: 1.14–2.21], survival rate at the endpoint [%]: 62.0 vs. 83.3). However, after adjusting for confounding variables using Cox proportional hazards regression, there was no significant effect of overall comorbid psychiatric disorders on prognosis.

Conclusion

Comorbid psychiatric disorders did not affect the survival rate of liver transplant recipients in this study.
Exploring the aging process of cognitively healthy adults by analyzing cerebrospinal fluid metabolomics using liquid chromatography-tandem mass spectrometry
Authors: Liu Fu-Chao , Cheng Mei-Ling , Lo Chi-Jen , Hsu Wen-Chuin , Lin Gigin , Lin Huan-Tang
Published: April 2023

Background

During biological aging, significant metabolic dysregulation in the central nervous system may lead to cognitive decline and neurodegeneration. However, the metabolomics of the aging process in cerebrospinal fluid (CSF) has not been thoroughly explored.

Methods

In this cohort study of CSF metabolomics using liquid chromatography-mass spectrometry (LC–MS), fasting CSF samples collected from 92 cognitively unimpaired adults aged 20–87 years without obesity or diabetes were analyzed.

Results

We identified 37 metabolites in these CSF samples with significant positive correlations with aging, including cysteine, pantothenic acid, 5-hydroxyindoleacetic acid (5-HIAA), aspartic acid, and glutamate; and two metabolites with negative correlations, asparagine and glycerophosphocholine. The combined alterations of asparagine, cysteine, glycerophosphocholine, pantothenic acid, sucrose, and 5-HIAA showed a superior correlation with aging (AUC = 0.982). These age-correlated changes in CSF metabolites might reflect blood–brain barrier breakdown, neuroinflammation, and mitochondrial dysfunction in the aging brain. We also found sex differences in CSF metabolites with higher levels of taurine and 5-HIAA in women using propensity-matched comparison.

Conclusions

Our LC–MS metabolomics of the aging process in a Taiwanese population revealed several significantly altered CSF metabolites during aging and between the sexes. These metabolic alterations in CSF might provide clues for healthy brain aging and deserve further exploration.
Diagnostic signature composed of seven genes in HIF-1 signaling pathway for preeclampsia
Authors: Yang Xun , Yu Ling , Ding Yiling , Yang Mengyuan
Published: April 2023

Purpose

In this study, we explored the relationship of genes in HIF-1 signaling pathway with preeclampsia and establish a logistic regression model for diagnose preeclampsia using bioinformatics analysis.

Method

Two microarray datasets GSE75010 and GSE35574 were downloaded from the Gene Expression Omnibus database, which was using for differential expression analysis. DEGs were performed the Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and Gene set enrichment analysis (GSEA). Then we performed unsupervised consensus clustering analysis using genes in HIF-1 signaling pathway, and clinical features and immune cell infiltration were compared between these clusters, as well as the least absolute shrinkage and selection operator (LASSO) method to screened out key genes to constructed logistic regression model, and receiver operating characteristic (ROC) curve was plotted to evaluate the accuracy of the model.

Results

57 DEGs were identified, of which GO, KEGG and analysis GSEA showed DEGs were mostly involved in HIF-1 signaling pathway. Two subtypes were identified of preeclampsia and 7 genes in HIF1-signaling pathway were screened out to establish the logistic regression model for discrimination preeclampsia from controls, of which the AUC are 0.923 and 0.845 in training and validation datasets respectively.

Conclusion

Seven genes (including MKNK1, ARNT, FLT1, SERPINE1, ENO3, LDHA, BCL2) were screen out to build potential diagnostic model of preeclampsia.