bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from Preexisting Immunity Drives the Response to Neoadjuvant Chemotherapy in Esophageal Adenocarcinoma
Authors: Arbore Giuseppina , Albarello Luca , Bucci Gabriele , Punta Marco , Cossu Andrea , Fanti Lorella , Maurizio Aurora , Di Mauro Francesco , Bilello Vito , Arrigoni Gianluigi , Bonfiglio Silvia , Biancolini Donatella , Puccetti Francesco , Elmore Ugo , Vago Luca , Cascinu Stefano , Tonon Giovanni , Rosati Riccardo , Casorati Giulia , Dellabona Paolo
Published: September 2023

Abstract
Current treatment for patients with locally advanced esophageal adenocarcinoma (EAC) is neoadjuvant chemotherapy (nCT), alone or combined with radiotherapy, before surgery. However, fewer than 30% of treated patients show a pathologic complete response to nCT, which correlates with increased 5-year survival compared with nonresponders. Understanding the mechanisms of response to nCT is pivotal to better stratify patients and inform more efficacious therapies. Here, we investigated the immune mechanisms involved in nCT response by multidimensional profiling of pretreatment tumor biopsies and blood from 68 patients with EAC (34 prospectively and 34 retrospectively collected), comparing complete responders versus nonresponders to nCT. At the tumor level, complete response to nCT was associated with molecular signatures of immune response and proliferation, increased putative antitumor tissue-resident memory CD39+ CD103+ CD8+ T cells, and reduced immunosuppressive T regulatory cells (Treg) and M2-like macrophages. Systemically, complete responders showed higher frequencies of immunostimulatory CD14+ CD11c+ HLA-DRhigh cells, and reduced programmed cell death ligand 1–positive (PD-L1+) monocytic myeloid-derived suppressor cells, along with high plasma GM-CSF (proinflammatory) and low IL4, CXCL10, C3a, and C5a (suppressive). Plasma proinflammatory and suppressive cytokines correlated directly and inversely, respectively, with the frequency of tumor-infiltrating CD39+ CD103+ CD8+ T cells. These results suggest that preexisting immunity in baseline tumor drives the clinical activity of nCT in locally advanced EAC. Furthermore, it may be possible to stratify patients based on predictive immune signatures, enabling tailored neoadjuvant and/or adjuvant regimens.
Significance:
Multidimensional profiling of pretreatment esophageal adenocarcinoma shows patient response to nCT is correlated with active preexisting immunity and indicates molecular pathways of resistance that may be targeted to improve clinical outcomes.
Data from Association between Sleep Duration and Colorectal Adenomas: Findings from a Case–Control Study in Vietnam
Authors: Tran Chi Thi-Du , Paragomi Pedram , Tran Mo Thi , Nguyen Mai Vu-Tuyet , Tuong Thuy Thi-Van , Tran Quang Hong , Le Linh Cu , Pham Huong Thi-Thu , Ha Hien Thi-Thu , Bui Nam Chi , Vu Hien Huy , Ta Phuong Que , Shrubsole Martha J. , Cai Qiuyin , Ye Fei , Le Song Huu , Vu Khien Van , Tran Huong Thi-Thanh , Tran Thuan Van , Boffetta Paolo , Shu Xiao-Ou , Luu Hung N.
Published: September 2023

AbstractBackground:
Colorectal cancer is one of the leading cancers worldwide and in Vietnam. Adenomas are important precursors of colorectal cancer. Study on the association between sleep duration and development of colorectal adenoma (CRA) is limited, particularly among Vietnamese population.
Methods:
We conducted an individually matched case–control study of 870 CRA cases and 870 controls in a large-scale colorectal screening program involving 103,542 individuals ages ≥40 years old in Hanoi, Vietnam. Sleep duration was categorized in three groups: short: ≤6 hours/day, normal: 7 to 8 hours/day, and long: >8 hours/day. Conditional logistic regression was used to evaluate the association between sleep duration and adenomas risk after controlling for potential confounders.
Results:
Overall, short-sleep duration was associated with increased risk of having CRA compared with normal duration [OR, 1.48; 95% confidence interval (CI), 1.12–1.97]. This pattern was present in both females (OR, 1.58; 95% CI, 1.14–2.18) and males (OR, 1.45; 95% CI, 1.08–1.93), with advanced adenomas (OR, 1.61; 95% CI, 1.09–2.38) and non-advanced adenomas (OR, 1.66; 95% CI, 1.19–2.32). Furthermore, the association between CRA development and short-sleep duration was more apparent among females who were nondrinker, nonobese, physically active, with proximal or both sided adenomas and with cardiometabolic disorder. Among males, the short-sleep duration was associated with CRA risk among never-smoking, cardiometabolic disorders, and obese.
Conclusions:
Short-sleep duration was associated with increased prevalence of both advanced and non-advanced CRAs among Vietnamese population.
Impact:
Findings from this study showed that maintaining an adequate sleep duration may have an important implication for colorectal adenoma prevention and control.
Data from Variations in Genes Encoding Human Papillomavirus Binding Receptors and Susceptibility to Cervical Precancer
Authors: Mukherjee Amrita , Ye Yuanfan , Wiener Howard W. , Kuniholm Mark H. , Minkoff Howard , Michel Kate , Palefsky Joel , D'Souza Gypsyamber , Rahangdale Lisa , Butler Kenneth R. , Kempf Mirjam-Colette , Sudenga Staci L. , Aouizerat Bradley E. , Ojesina Akinyemi I. , Shrestha Sadeep
Published: September 2023

AbstractBackground:
Cervical cancer oncogenesis starts with human papillomavirus (HPV) cell entry after binding to host cell surface receptors; however, the mechanism is not fully known. We examined polymorphisms in receptor genes hypothesized to be necessary for HPV cell entry and assessed their associations with clinical progression to precancer.
Methods:
African American women (N = 1,728) from the MACS/WIHS Combined Cohort Study were included. Two case–control study designs were used—cases with histology-based precancer (CIN3+) and controls without; and cases with cytology-based precancer [high-grade squamous intraepithelial lesions (HSIL)] and controls without. SNPs in candidate genes (SDC1, SDC2, SDC3, SDC4, GPC1, GPC2, GPC3, GPC4, GPC5, GPC6, and ITGA6) were genotyped using an Illumina Omni2.5-quad beadchip. Logistic regression was used to assess the associations in all participants and by HPV genotypes, after adjusting for age, human immunodeficiency virus serostatus, CD4 T cells, and three principal components for ancestry.
Results:
Minor alleles in SNPs rs77122854 (SDC3), rs73971695, rs79336862 (ITGA6), rs57528020, rs201337456, rs11987725 (SDC2), rs115880588, rs115738853, and rs9301825 (GPC5) were associated with increased odds of both CIN3+ and HSIL, whereas, rs35927186 (GPC5) was found to decrease the odds for both outcomes (P value ≤ 0.01). Among those infected with Alpha-9 HPV types, rs722377 (SDC3), rs16860468, rs2356798 (ITGA6), rs11987725 (SDC2), and rs3848051 (GPC5) were associated with increased odds of both precancer outcomes.
Conclusions:
Polymorphisms in genes that encode binding receptors for HPV cell entry may play a role in cervical precancer progression.
Impact:
Our findings are hypothesis generating and support further exploration of mechanisms of HPV entry genes that may help prevent progression to cervical precancer.
Data from The GENIE BPC NSCLC Cohort: A Real-World Repository Integrating Standardized Clinical and Genomic Data for 1,846 Patients with Non–Small Cell Lung Cancer
Authors: Choudhury Noura J. , Lavery Jessica A. , Brown Samantha , de Bruijn Ino , Jee Justin , Tran Thinh Ngoc , Rizvi Hira , Arbour Kathryn C. , Whiting Karissa , Shen Ronglai , Hellmann Matthew , Bedard Philippe L. , Yu Celeste , Leighl Natasha , LeNoue-Newton Michele , Micheel Christine , Warner Jeremy L. , Ginsberg Michelle S. , Plodkowski Andrew , Girshman Jeffrey , Sawan Peter , Pillai Shirin , Sweeney Shawn M. , Kehl Kenneth L. , Panageas Katherine S. , Schultz Nikolaus , Schrag Deborah , Riely Gregory J.
Published: September 2023

AbstractPurpose:
We describe the clinical and genomic landscape of the non–small cell lung cancer (NSCLC) cohort of the American Association for Cancer Research (AACR) Project Genomics Evidence Neoplasia Information Exchange (GENIE) Biopharma Collaborative (BPC).
Experimental Design:
A total of 1,846 patients with NSCLC whose tumors were sequenced from 2014 to 2018 at four institutions participating in AACR GENIE were randomly chosen for curation using the PRISSMM data model. Progression-free survival (PFS) and overall survival (OS) were estimated for patients treated with standard therapies.
Results:
In this cohort, 44% of tumors harbored a targetable oncogenic alteration, with EGFR (20%), KRAS G12C (13%), and oncogenic fusions (ALK, RET, and ROS1; 5%) as the most frequent. Median OS (mOS) on first-line platinum-based therapy without immunotherapy was 17.4 months [95% confidence interval (CI), 14.9–19.5 months]. For second-line therapies, mOS was 9.2 months (95% CI, 7.5–11.3 months) for immune checkpoint inhibitors (ICI) and 6.4 months (95% CI, 5.1–8.1 months) for docetaxel ± ramucirumab. In a subset of patients treated with ICI in the second-line or later setting, median RECIST PFS (2.5 months; 95% CI, 2.2–2.8) and median real-world PFS based on imaging reports (2.2 months; 95% CI, 1.7–2.6) were similar. In exploratory analysis of the impact of tumor mutational burden (TMB) on survival on ICI treatment in the second-line or higher setting, TMB z-score harmonized across gene panels was associated with improved OS (univariable HR, 0.85; P = 0.03; n = 247 patients).
Conclusions:
The GENIE BPC cohort provides comprehensive clinicogenomic data for patients with NSCLC, which can improve understanding of real-world patient outcomes.
Data from Clec4A4 Acts as a Negative Immune Checkpoint Regulator to Suppress Antitumor Immunity
Authors: Uto Tomofumi , Fukaya Tomohiro , Mitoma Shuya , Nishikawa Yotaro , Tominaga Moe , Choijookhuu Narantsog , Hishikawa Yoshitaka , Sato Katsuaki
Published: September 2023

Abstract
Clec4A4 is a C-type lectin receptor (CLR) exclusively expressed on murine conventional dendritic cells (cDC) to regulate their activation status. However, the functional role of murine Clec4A4 (mClec4A4) in antitumor immunity remains unclear. Here, we show that mClec4A4 serves as a negative immune checkpoint regulator to impair antitumor immune responses. Deficiency of mClec4A4 lead to a reduction in tumor development, accompanied by enhanced antitumor immune responses and amelioration of the immunosuppressive tumor microenvironment (TME) mediated through the enforced activation of cDCs in tumor-bearing mice. Furthermore, antagonistic mAb to human CLEC4A (hCLEC4A), which is the functional orthologue of mClec4A4, exerted protection against established tumors without any apparent signs of immune-related adverse events in hCLEC4A-transgenic mice. Thus, our findings highlight the critical role of mClec4A4 expressed on cDCs as a negative immune checkpoint molecule in the control of tumor progression and provide support for hCLEC4A as a potential target for immune checkpoint blockade in tumor immunotherapy.
MRD and Plasma Cell Dynamics after CAR T-cell Therapy in Myeloma
Authors: Landgren Ola , Kazandjian Dickran
Published: September 2023

In this issue, Paiva and colleagues characterize the dynamics of minimal residual disease (MRD) and clinical responses during chimeric antigen receptor (CAR) T-cell therapy of relapsed/refractory multiple myeloma. Although both correlate with prolonged progression-free survival, MRD is reached faster in the bone marrow than complete response in peripheral blood; consequently, the study addresses the need for future guidelines to explore new MRD-negative definitions that are independent of the monoclonal (M) protein to overcome this limitation, particularly in clinical trials using early depth of response as an endpoint.

See related article by Paiva et al., p. 365 (1).
Thromboelastography and Traditional Coagulation Testing in Non-ICU-Admitted Patients with Acute Kidney Injury: An Observational Cohort Study
Authors: Liu Jiajia , Liu Zhongyuan , Zhao Tao , Su Tao , Jin Qizhuang
Published: September 2023

Introduction: This study aimed to elucidate the coagulation disorders in non-ICU patients with acute kidney injury (AKI) and their contribution to clotting-related outcomes of intermittent kidney replacement therapy (KRT). Methods: We included non-ICU-admitted patients with AKI requiring intermittent KRT, clinically having a risk of bleeding and against systemic anticoagulant use during KRT between April and December 2018. The premature termination of treatment due to circuit clotting was considered a poor outcome. We analyzed the characteristics of thromboelastography (TEG)-derived and traditional coagulation parameters and explored the potential-affecting factors. Results: In total, 64 patients were enrolled. Hypocoagulability was detected in 4.7%–15.6% of patients by a combination of the traditional parameters, i.e., prothrombin time (PT)/international normalized ratio, activated partial PT, and fibrinogen. No patient had hypocoagulability observed on TEG-derived reaction time; only 2.1%, 3.1%, and 10.9% of patients had hypocoagulability on TEG-derived kinetic time (K-time), α-angle, and maximum amplitude (MA), respectively, which were also platelet-related coagulation parameters, despite 37.5% of the cohort having thrombocytopenia. In contrast, hypercoagulability was more prevalent, involving 12.5%, 43.8%, 21.9%, and 48.4% of patients on TEG K-time, α-angle, MA, and coagulation index (CI), respectively, although thrombocytosis was only in 1.5% of the cohort. Patients with thrombocytopenia showed lower fibrinogen level (2.6 vs. 4.0 g/L, p = 0.00), α-angle (63.5° vs. 73.3°, p = 0.00), MA (53.5 vs. 66.1 mm, p = 0.00), and CI (1.8 vs. 3.6, p = 0.00) but higher thrombin time (17.8 vs. 16.2 s, p = 0.00) and K-time (2.0 vs. 1.2 min, p = 0.00) than those with a platelet count over 100 × 109/L. 41 patients were treated with heparin-free protocol, and 23 were treated with regional citrate anticoagulation (RCA). The premature termination rate was 41.5% on heparin-free patients, while 8.7% of patients underwent an RCA protocol (p = 0.006). Heparin-free protocol was the strongest adverse factor to poor outcomes. A heparin-free subgroup analysis found that the circuit clotting risk was increased by 61.7% with a 10 × 109/L elevation in platelet count (odds ratio [OR] = 1.617, p = 0.049) and decreased by 67.5% following a second increase of PT (OR = 0.325, p = 0.041). No significant correlation was found between TEG parameters and premature circuit clotting. Conclusions: Most non-ICU-admitted patients with AKI had normal-to-enhanced hemostasis and activated platelet function based on TEG results, as well as a high rate of premature circuit clotting when receiving heparin-free protocol despite thrombocytopenia. Further studies are needed to better determine the use of TEG in respect to management of anticoagulation and bleeding complications in AKI patients with KRT.
Prostatakarzinom: Individuelle Faktoren sollten die Auswahl des am besten geeigneten Behandlungsansatzes bestimmen
Authors: Knipper Anne-Sophie
Published: September 2023

Zwischen 1999 und 2009 wurden in Großbritannien über 82 000 Männer zwischen 50 und 69 Jahren auf Prostatakrebs getestet, wobei bei etwa 2664 Männern eine lokalisierte Prostatakrebserkrankung diagnostiziert wurde. Von diesen Männern nahmen 1643 an einer Studie teil, um die Wirksamkeit verschiedener Behandlungen zu untersuchen. Ein Teil der Männer wurde der aktiven Überwachung zugeordnet, während andere sich einer Prostatektomie oder Strahlentherapie unterzogen. Nach einer Nachbeobachtungszeit von 15 Jahren wurden die Ergebnisse verglichen, um die Sterblichkeit aufgrund von Prostatakrebs (primärer Endpunkt) sowie Todesfälle jeglicher Ursache, das Auftreten von Metastasen, die Krankheitsprogression und die Einleitung einer langfristigen Androgendeprivationstherapie (sekundäre Endpunkte) zu untersuchen. Es stellte sich heraus, dass die Prostatakrebssterblichkeit trotz unterschiedlicher Behandlungen gering war. Die Wahl der Therapie sollte daher sorgfältig getroffen werden, da es bei lokalisiertem Prostatakrebs eine Abwägung zwischen den Vorteilen und Risiken der verschiedenen Behandlungen gibt.
Insomnia pada Lansia: Tantangan dalam Mendiagnosis dan Pemberian Perawatan
Authors: Fatma Siti , Sunarti Sri
Published: September 2023

Perubahan pola tidur pada usia lanjut sering terjadi, bisa sebagai proses fisiologis atau merupakan bagian dari penyakit kronis tertentu. Insomnia adalah salah satu gangguan yang paling banyak dikeluhkan oleh pasien usia lanjut, dan dipengaruhi oleh beberapa faktor seperti perubahan fisiologis, kebiasaan tidur, adanya penyakit – penyakit komorbid, juga bisa karena efek samping obat – obatan yang dikonsumsi. Untuk itu diperlukan skrining tersendiri agar bisa melakukan penilaian klinis komprehensif pada pasien usia lanjut seperti gangguan tidur primer, penyakit komorbid, gangguan mental seperti depresi dan cemas. Penatalaksanaan insomnia ini merupakan tantangan tersendiri dalam diagnosis dan terapi karena dibutuhkan perawatan komprehensif meliputi perubahan gaya hidup, kontrol penyakit komorbid, dan juga manajemen efek samping obat, sehingga nantinya bisa ditentukan terapi yang paling tepat dan efektifitas obat yang optimal.
Potensi Implementasi Telemedicine (Telekonsultasi, Telemonitoring, dan Telenutrisi) pada Penyakit Kronis Pasca Pandemi COVID-19 sebagai Upaya Resiliensi Bangsa Indonesia
Authors: Prawestiningtyas Eriko , Hamada Muhammad , Aulia Nur , Puspitasari Diyah , Yusuf Vincetius , Amar Nasim
Published: September 2023

Pendahuluan: COVID-19 telah berkembang menjadi pandemi dan menarik perhatian negara di penjuru dunia termasuk Indonesia. Adanya pembatasan mobilitas masyarakat berakibat pada berkurangnya akses pelayanan kesehatan bagi pasien non-COVID-19 dan mengakibatkan sebagian besar pasien dengan penyakit kronis enggan untuk melakukan perawatan. Pemberian layanan kesehatan perlu dipersiapkan dengan suatu strategi dimana transmisi COVID-19 dapat diminimalisir, namun layanan tetap dapat diberikan secara efektif, efisien, dan aman. Salah satu upaya yang dapat dilakukan dengan menggunakan telemedicine yang mencakup telekonsultasi, telemonitoring, dan telenutrisi. Di Indonesia, regulasi penggunaan telemedicine sudah diatur dalam undang-undang.

Tujuan: untuk mengetahui potensi implementasi dari telemedicine (telekonsultasi, telemonitoring, telenutrisi) pada penyakit kronis pasca pandemi COVID-19.

Metode: studi literatur yang telah dilakukan dalam rentang waktu publikasi 10 tahun terakhir yaitu 2011-2021 serta didapatkan dari database “PUBMED”, “Science Direct”, dan “Cochrane” dengan menggunakan kata kunci “Teleconsultation”, “Telenutrition”, “Telemonitoring”, dan “Chronic disease”.

Hasil dan Kesimpulan: Didapatkan 19 artikel yang valid dan reliabel berdasarkan kriteria inklusi menyatakan bahwa penggunaan telemedicine (telekonsultasi, telemonitoring dan telenutrisi) dapat meningkatkan kualitas hidup, memperbaiki outcome pasien serta menurunkan mortalitas dan morbiditas terutama pada pasien dengan penyakit kronis. Pasien juga merasa puas dan merekomendasikan penggunaan telemedicine dalam masa mendatang. Dibutuhkan studi lanjutan terkait penggunaan telemedicine pada pasien dengan penyakit kronis, terutama di masa pasca pandemi COVID-19.
A Challenge To Treat Hypoglycemia For The Diabetic Elderly Patient In Daily Clinical Practice
Authors: Rochmah Izzah , Erwan Nabila , Mumtaza Hilya
Published: September 2023

Background: Hypoglycemia is an acute complication that often occurs in daily clinical practice. The incidence of hypoglycemia is increased, one of which is by age factors and the use of insulin.

Case Presentation: A 66-years old Indonesian woman with obesity (BMI=35.2 kg/m2) came to Emergency Department (ED) with decreased of consciousness due to a skipped meal after a prandial insulin injection with errors in calculating insulin dose. She had Diabetes Mellitus type 2 since 10 years ago and got insulin prescription since last year. The random blood sugar (RBG) was 27 mg/dl. Patient was administered intravenous D40% 75ml and the symptoms was improved. Patient was diagnosed this patient with severe hypoglycemia.  During hospitalization, patient’s blood sugar had fluctuation in 2 days consecutive mornings and began to stable in day 3 on ward. When the patient discharged, we prescribed 24U basal insulin given before bed if the RBG level >200mg/dl.

Discussion: In older population, the neuroglycopenic symptoms, such as  lethargy, dizziness, and delirium appear in higher BG level than the autonomic symptoms. The disproportion of demand and supply of blood glucose in the brain causes the neuroglycopenic symptoms. In addition, those signs are also likely to be misinterpreted as signs of stroke, dementia, or vision problems. This cycle of misidiagnosed and the tendency of neuroglypenic symptoms lead the older population into hypoglycemia unawareness.

Conclusion: Hypoglycemia unawareness is one of the warning signs of the severity of Diabetes Mellitus type 2 caused by multiple factors which has high prevalence in the elderly. Therefore, particular management is needed in this population by selecting the suitable glucose-lowering agent considering individualized patient preferences rather than focusing on the glycemic target.
Sentido de comunidad de adolescentes en escuelas y barrios durante el covid-19
Authors: Oyarzún-Gómez Denise , Dauvin-Herrera Cristóbal
Published: September 2023

(analítico)El sentido de comunidad de jóvenes es la sensación de pertenencia de este grupo en relación con la escuela o el barrio. Es un tema estudiado en las ciencias sociales, aunque sus transformaciones no han sido suficientemente visibilizadas. El propósito del estudio es describir las percepciones del sentido de comunidad en la escuela y el barrio durante el covid-19 en estudiantes de 14 a 18 años de escuelas públicas, subvencionadas y privadas en la Región Metropolitana de Chile. Con metodología cualitativa, descriptiva y transversal, desde la fotoprovocación virtual, se analizan temáticamente las  perspectivas juveniles. Los resultados muestran que el sentido de comunidad escolar está tensionando el relacionamiento interpersonal, emergiendo afectos negativos y destacando la pertenencia al espacio físico. El sentido de comunidad en el barrio es incipiente durante la pandemia.
Palabras clave:  Escuela secundaria; comunidad; jóvenes; virus; Chile. Tesauro de Ciencias Sociales de la Unesco.
Representaciones de estudiantes sobre el conflicto mapuche en Chile y Argentina
Authors: Sanhueza-Rodríguez Alexis , Jara Miguel Ángel
Published: September 2023

(analytical)Research on social representations constructed by students in relation to contemporary problems represents a fundamental space for investigative exploration. This study sought to analyze the representations of Chilean and Argentine primary school students regarding the "conflict" between the Chile, Argentina and the Mapuche people. The research was qualitative and used a grounded theory approach. The data was collected through holding focus groups in Chilean and Argentine schools. The analysis involved the use of coding paradigm procedures in order to investigate social representations in a procedural and structural way. The results reveal the role that students give to the teaching of History. The conclusions identify that the teaching of History does not contribute to the understanding of this problem.
Keywords: Social science education; primary school students; indigenous peoples; visualization.
Cartografías artísticas: jóvenes autores de la construcción del pasado reciente
Authors: Cardona-Salazar Lina Marcela , Ospina-Ramírez David Arturo , Ospina-Alvarado María Camila
Published: September 2023

(analytical)This article presents the results of a research project that sought to understand the ways in which young people construct their ideas and imaginaries about the recent past in Colombia. The research was conducted in the city of Manizales with the participation of 24 young people between 12 and 18years of age. The research was carried out using cartographies of experiences from the recent pastand the reconstruction of collective memory. It was identified that young people use signs that havebeen traditionally used to represent peace and memory. Dialogue and creative processes generatereflection spaces in which these signs are transcended and broader meanings are constructed, which in turn allow them to narrate their life experiences.
Keywords: Collective memory; history teaching; childhood; school.
Evolución del riesgo y protección en la infancia y la adolescencia
Authors: Tomás José M. , Fernández Irene , Navarro-Pérez José-Javier , Carbonell Ángela
Published: September 2023

(analítico)Los factores de riesgo y protección pueden ser utilizados para evaluar, prevenir e intervenir en el maltrato infantil. El objetivo de este estudio es analizar longitudinalmente el riesgo en la infancia y la adolescencia, para determinar qué factores pueden ser empleados como indicadores de evolución. Se empleó una muestra de 102 niños, niñas y adolescentes que participaban en el sistema de bienestar infantil español, en tres momentos temporales. Los resultados indicaron que existe una evolución del riesgo, con una tendencia general de disminución de riesgos e incremento de elementos protectores. Nuestros hallazgos identificaron la existencia de factores dinámicos y estáticos. Este estudio pone de manifiesto la relevancia de la atención e intervención continuada y a largo plazo para fortalecer los factores de protección y disminuir los de riesgo en niños, niñas y adolescentes.
Palabras clave:  Maltrato infantil; adolescencia; bienestar de la infancia; factores de riesgo; factores de protección. Tesauro de Ciencias Sociales de la Unesco.
El bullying: una mirada desde los niños y las niñas
Authors: Gutiérrez-Vega Ingrit , Sánchez-Rodriguez Carlos Alfonso , Londoño-Vásquez David Alberto
Published: September 2023

(analítico)Se presentan los resultados sobre cómo se comprende y se asume el bullying, en tanto problema escolar y social, desde la perspectiva infantil. Para ello, se realizó una investigación cualitativa, hermenéutico- comprensiva, con grupos focales mediados por títeres o videos, producción gráfica y narración de historias. Los participantes fueron 626 estudiantes de 5 a 7 años. La comprensión transitó por elementos congruentes con la teoría, como exclusión, acoso verbal, afectación de pertenencias y una nueva tipología: falta de solidaridad. En cuanto a las experiencias, precisan las burlas, el acoso físico y el hurto, asociadas al contexto familiar o a ninguna, estas últimas por la confluencia del espacio escolar y la familia en un mismo lugar en tiempos de educación remota. En cuanto a la solución, está apela a figuras de autoridad, familiares, asumir actitudes reconciliadoras o al juego.
Palabras clave:  Acoso escolar; entorno familiar; escuela rural; participación infantil. Tesauro de Ciencias Sociales de la Unesco.
Resiliencia académica, rendimiento e intención de abandono en estudiantes universitarios de Quito
Authors: Zumárraga-Espinosa Marcos
Published: September 2023

(analytical)Academic resilience is the individual ability to respond adaptively to the adversities of the educational process and overcome them successfully. This study explores the effects of academic resilience in a sample of Psychology students (N=550) from Quito-Ecuador. The results of regression analyses show that resilience is positively related to academic performance and negatively related to the intention to drop out of university studies. Regarding the dimensions of academic resilience: a) perseverance, b) reflecting and adaptive help-seeking, and c) negative affect and emotional response, these present a pattern of differentiated influence on performance and dropout intention. Likewise, the favorable effects of resilience are greater for students at initial levels of career, and are reduced for students at higher levels.
Keywords: Resilience; academic performance; desertion; university; academic resilience; dropout intention; Ecuador.
Corpo-Substância: um corpo com bonecos
Authors: Santos Adriana Maria Cruz dos
Published: September 2023

Este artigo traz apontamentos sobre uma investigação artística no grupo In Bust Teatro com Bonecos e, posteriormente se expande para dialogar com procedimentos gerados no jogo da cena de diferentes atuantes da linguagem do teatro de animação com o boneco, elemento expressivo significante dessa cena. Este trabalho sugere reflexões sobre o campo artístico e a invenção de um corpo construído no espaço-tempo deste jogo: um corpo-substância. Observa-se a relevância do encontro, que se instaurou como operador metodológico para desenvolver a pesquisa.
Causal Effects of YKL‐40 on Ischemic Stroke and Its Subtypes: A 2‐Sample Mendelian Randomization Study
Authors: Xu Qingyun , Sun Lulu , Wang Yinan , Wang Ruirui , Jia Yiming , Guo Daoxia , Shi Mengyao , Yang Pinni , Zhang Yonghong , Zhu Zhengbao
Published: September 2023

Background

Chitinase‐3 like protein 1 (CHI3L1, YKL‐40) was reported to be implicated in the development of ischemic stroke, but whether the association between them was causal remained unclear. We conducted a 2‐sample Mendelian randomization study to explore the associations of genetically determined plasma YKL‐40 with ischemic stroke and its subtypes (large artery stroke, small vessel stroke, and cardioembolic stroke).

Methods and Results

Based on genome‐wide association study data of 3394 European‐descent individuals, we selected 13 single‐nucleotide polymorphisms associated with plasma YKL‐40 as genetic instruments. Summary data about ischemic stroke and its subtypes were obtained from the Multiancestry Genome‐wide Association Study of Stroke Consortium, involving 34 217 ischemic stroke cases and 406 111 controls of European ancestry. We used the inverse‐variance weighted method followed by a series of sensitivity analyses to assess the causal associations of plasma YKL‐40 with ischemic stroke and its subtypes. The primary analysis showed that genetically determined high YKL‐40 levels were associated with increased risks of large artery stroke (odds ratio [OR], 1.08 [95% CI, 1.04–1.12];
P
=1.73×10
−4
) and small vessel stroke (OR, 1.05 [95% CI, 1.01–1.09];
P
=7.96×10
−3
) but not with ischemic stroke or cardioembolic stroke. Sensitivity analyses further confirmed these associations, and Mendelian randomization‐Egger indicated no evidence of genetic pleiotropy. In addition, supplementary analysis based on the summary data from the Olink proximity extension assay cardiovascular I (Olink CVD‐I) panel showed that high YKL‐40 levels were positively associated with the risks of large artery stroke (OR, 1.15 [95% CI, 1.08–1.22];
P
=4.16×10
−6
) but not with small vessel stroke.

Conclusions

Genetically determined high plasma YKL‐40 levels were causal associated with increased risks of large artery stroke.
Flaviporus albus (Steccherinaceae), a new species from southern China based on morphological and phylogenetic evidence
Authors: WEI QIU-LU , ZHENG HAI-FU , SHAO YUAN-YUAN , RASHEED USMAN , HUANG HAI-SI , HUANG FU-CHANG , LIU BIN
Published: September 2023

Flaviporus is a small genus within the wood-inhabiting family Steccherinaceae. Macroscopically, it is characterized by watery and resinous basidiomes that become hard and tend to shrink when dried, and microscopically by agglutinated hyphae that are difficult to observe. The present study proposes Flaviporus albus sp. nov. as a new species based on morphological and phylogenetic evidence. It is characterized by a white to cream pileus surface, small pores (10–14 per mm) with irregular dissepiments, and the presence of rather thin-walled to thick-walled skeletocystidia. The basidiospores are broadly ellipsoid to subglobose, measuring 2.1–2.6×1.7–2.3 μm, commonly with an oil drop, hyaline and have a thickened wall. These basidiospores do not show any reaction to Melzer’s or Cotton Blue. Furthermore, this study presents a key to the globally known species of Flaviporus.
On the identity and distribution of Chrysopogon velutinus (Poaceae: Andropogoneae) and its taxonomic comparison with allied species in India
Authors: LANDGE SHAHID NAWAZ , SHINDE RAJENDRA D.
Published: September 2023

Andropogon velutinus (a basionym of Chrysopogon velutinus) is lectotypified by selecting one of the original materials housed at the Kew Herbarium. So far, the species is only known to occur in the states of Maharashtra, Karnataka, Andhra Pradesh, and Telangana in Peninsular India. However, it has seemingly been reported from Kerala state, but we did not find any confirmed specimens in the consulted herbaria. Chrysopogon velutinus is quite similar to C. fulvus, and it has been misidentified as the latter on many occasions. We discussed the correct identity and distribution of C. velutinus in India and also compared it with the C. fulvus complex. A photo plate of the specimen of C. fulvus resembling an African species Chrysopogon plumulosus is also given to show the extremity of variable forms in Chrysopogon fulvus complex. A key to distinguishing closely allied species is provided for precise identification. Additionally, photo plates showing varying habitats and morphological characters of C. velutinus are included and also distribution map showing the occurrence of the species in India.
Changes in the Global Climate: Atmospheric Angular Momentum and Pacific Ocean Temperatures
Authors: Weickmann Klaus , Berry Edward , Gensini Victor , Gold David , Petroski Thomas
Published: September 2023

Atmospheric angular momentum (AAM) is used to study the variability of Earth’s atmospheric circulation during the past 45 years, a time of considerable climate change. Using global AAM, two interdecadal states are defined covering the periods 1977–98 (hereinafter P1) and 1999–2022 (P2). Global AAM decreased from P1 to P2 and was accompanied by weakened subtropical jet streams in both hemispheres, strong convection around the northern Maritime Continent, and a strengthened sea surface temperature (SST) gradient across the tropical Pacific Ocean. The period differences project onto 1) internal interdecadal Pacific variability (IPV), 2) a postulated transient ocean thermostat response to greenhouse gas and aerosol emissions, and 3) circulation anomalies related to the ozone hole. During 1977–2023, the first two processes are forcing the climate toward larger Pacific Ocean SST gradients and a poleward expansion of the Indo-Pacific warm pool (IPWP), especially into the Northern Hemisphere. The ozone hole produces its own distinct pattern of anomalies in the Southern Hemisphere that tend to become persistent in the early 1990s. The zonal and vertical mean AAM variations during P1 have frequent westerly wind anomalies between 40°N and 40°S with poleward propagation on interannual time scales. During P2, the circulation is dominated by subtropical easterly wind anomalies, poleward-shifted jets, and weaker propagation. Locally, the zonal mean anomalies manifest as midlatitude ridges that lead to continental droughts. Case studies illustrate the weakened subtropical jet streams of P2 and examine the factors behind a transition to La Niña in early 2020 that maintains the P2 pattern.
Impact of Patient and Procedural Factors on Outcomes Following Mesenteric Bypass
Authors: Zickler William P. , Zambetti Benjamin R. , Zickler Christine L. , Zickler Michael K. , Byerly Saskya , Garrett H. Edward , Magnotti Louis J.
Published: September 2023

Background

Mesenteric bypass (MB) for patients with acute (AMI) and chronic mesenteric ischemia (CMI) is associated with cardiovascular (CV) and pulmonary morbidity.

Methods

Patients with AMI and CMI from 2008 to 2019 were identified to determine independent predictors of CV (cardiac arrest, MI, DVT, and stroke) and pulmonary (pneumonia and ventilator time>48 h) morbidities in patients undergoing MB.

Results

377 patients were identified. Patients with AMI had higher rates of preoperative SIRS/sepsis (28 vs 12%, P < .0001), were more likely to be ASA class 4/5 (55 vs 42%, P = .005), were more likely to require bowel resection (19 vs 3%, P < .0001), and were more likely to have vein utilized as their bypass conduit (30 vs 14%, P < .0001). There were no differences in use of aortic or iliac inflow ( P = .707) nor in return to the OR (24 vs 19%, P = .282). Both postoperative sepsis (12 vs 2.6%, P = .003) and mortality (31.4% vs 9.8%, P < .0001) were significantly increased in patients with AMI. After adjusting for both patient and procedural factors, multivariable logistic regression (MLR) identified international normalized ratio (INR) (OR 3.16; 95% CI 1.56-6.40, P = .001) and chronic heart failure (CHF) (OR 5.88; 95% CI 1.15-29.97, P = .033) to be independent predictors of pulmonary morbidity, while preoperative sepsis (OR 1.96; 95% CI 1.45-2.66, P < .0001) alone was predictive of CV morbidity in all patients undergoing MB.

Discussion

Mesenteric bypass for mesenteric ischemia leads to high rates of morbidity and mortality, whether done in an acute or chronic setting. Preoperative sepsis, independent of AMI or CMI, predicts CV morbidity, regardless of bypass configuration or conduit, while elevated INR or underlying CHF carries a higher risk of pulmonary morbidity.
The Connell Stitch: A Two-Generation Contribution to Gastrointestinal Surgery
Authors: Lundberg Rachel K. , Elftmann Ashlyn E. , Wilson Stuart D. , Gamblin T. Clark
Published: September 2023

The history of the Connell Stitch begins at the Milwaukee County Hospital in 1887 and continues across two generations of surgeons, Dr. M.E. Connell and Dr. F Gregory Connell. With this historical article, we review the evolution of the Connell stitch in context of the surgeons responsible for the stitch’s development and evolution. Understanding the history of the Connell stitch facilitates a better appreciation for the Connell Stitch that we know and use today.
Making meaning of multimorbidity and severe mental illness: A viewpoint
Authors: Halstead Sean , Siskind Dan , Warren Nicola
Published: September 2023

People living with severe mental illness, such as schizophrenia and bipolar affective disorder, frequently experience poorer physical health compared to those without mental illness. This issue has hitherto been approached through the disease-centred construct of comorbidity, where subsequent conditions are viewed as secondary to an ‘index condition’. In contrast, this Viewpoint sets out to explain why multimorbidity, a patient-centred concept that instead refers to the coexistence of multiple chronic illnesses, is a more versatile and robust framework for tackling the issue of poor physical health in people with severe mental illness. In establishing this argument, this Viewpoint has sought to address three key areas. First, this article will discuss the epidemiology of both physical and psychiatric multimorbidity, with respect to how they manifest at greater frequency and at younger ages in people with severe mental illness. Second, the profound consequences of this multimorbidity burden will be explored, with respect to the ‘three D’ s’ of death (premature mortality), disability (functional impacts) and deficit (health-economic impacts). Finally, the utility of multimorbidity as a framework will be illustrated through a proposal for a three-dimensional multimorbidity construct composed of (1) quantity, (2) severity and (3) duration of an individual’s chronic illnesses. Consequently, this Viewpoint aims to capture why it is necessary for modern psychiatry to grasp the concept of multimorbidity to facilitate holistic healthcare for people living with severe mental illness.
The Human Costs of the War on Drugs. Attitudes Towards Militarization of Security in Mexico
Authors: Masullo Juan , Morisi Davide
Published: September 2023

Citizens in multiple crime-ridden countries strongly support the militarization of security—that is, placing the military in charge of traditional policing duties. Yet, we know little about the determinants of such support. Do people approve of militarization even in the face of human fatalities? We explore this question in the context of Mexico’s “war on drugs.” In three experimental studies, we manipulate the presence of human costs in a military operation against a drug lord and present arguments either justifying or condemning these costs. We consistently find that, even in successful operations, support for militarization decreases when military operations cause civilian casualties, but not when the victims are members of drug cartels. This finding holds for both respondents who have been victims of cartel-related violence and those who have not. Arguments that justify these costs as helping to achieve the end goal of eradicating organized crime increase support. These findings shed light on the public opinion side of the militarization of security debate, and have important implications for security policy reform and democratic politics.
A multivariable sliding mode predictive control method for the air management system of automotive fuel cells
Authors: Yang Duo , Fu Hanwen , Li Junjun , Wang Siyu
Published: September 2023

The proton exchange membrane fuel cell gas control has been one key point in fuel cell management systems. The complexity and coupling of the air management system make it difficult to achieve precise air intake adjustment. In this paper, an accurate joint control method for the air flow and pressure regulation is proposed. The nonlinear mathematical model of the air management system is developed to describe the output characteristic and state change. Based on this, the feedback linearization method is proposed to obtain the direct correspondence between control variables and controlled variables. In addition, to solve the problem that the controlled variables cannot be measured directly, an extended state observer is applied to estimate the stack cathode pressure. The sliding mode predictive control method is proposed to control the oxygen excess ratio and cathode pressure simultaneously. The relative order of the system is used to design the sliding mode surface, and the corresponding predictive model is proposed. The results obtained by simulation experiments show that pressure and mass flow have little effect on each other through decoupling. The proposed algorithm has been verified to have high precision, fast response, and robustness through comparative experiments.
Transient stability enhancement in renewable energy integrated multi-microgrids: A comprehensive and critical analysis
Authors: Liaqat Marriam , Alsuwian Turki , Amin Arslan Ahmed , Adnan Muhammad , Zulfiqar Adil
Published: September 2023

Multi-microgrids offer various benefits including the decreased overloading of a single microgrid, more options during faulty conditions, and more utilization of renewable energy resources. However, the implementation of a multi-microgrid brings the challenges such as power system complexity, interconnection issues, bidirectional power flow management, and power flow balancing. In the presence of these challenges, the power flow stability of the multi-microgrids is a challenging problem. In this context, this study evaluates a transient stability analysis model in multi-microgrids using solar photovoltaics, wind power, and a unified power flow controller (UPFC). UPFC offers a more robust power flow control strategy compared with other flexible alternating current transmission systems (FACTS) devices. First, a multi-microgrid structure consisting of the two microgrids was designed in DIgSILENT PowerFactory software. Second, the load flow calculation was performed in the absence and presence of UPFC, short circuit fault, and grid connection. Third, the electromagnetic transients (EMT) simulation was performed for all these situations. The results exhibited that the UPFC would offer significant power flow stability in the multi-microgrids. It was observed that the UPFC resulted in more transient stability in the microgrid where it was located. However, it improved the power flow quality at all the locations in the multi-microgrids. In addition, UPFC offered significant transient stability during the fault occurrence. The results offer various insights into power flow management in multi-microgrids.
The Personalist Basis of the Church's Teaching on Human Sexuality and the Natural Law in the Work of John Paul II. Part II
Authors: Fedoryka Maria
Published: September 2023

Responding to Pope John Paul II's call to give the “ethical grounds and personalistic reasons” behind the Church's teaching on sexual morality, this reflection written over the span of two articles analyzes the norms of the natural law related to human sexuality from a personalist perspective. The key ideas of this study are drawn from two passages: one from Gaudium et spes which states that “The sexual characteristics of man and the human faculty of reproduction wonderfully exceed the dispositions of lower forms of life”, the other from Humanae vitae stating that “Conjugal love reveals its true nature and nobility when it is considered in its supreme origin, God, who is love … and it is of supreme importance to have an exact idea of these.” (9) Drawing on the analysis of parts I and II shows, first, that the spousal act is in its original structure an “embodying act” intrinsically fashioned to embody spousal love: the self-donation, the intimacy, and the fruitfulness proper to the spirit's act of love animates the bodily act of sex from within, so that the spirit and the body form “one thing” in the spousal act. Secondly, this truth about the spousal act as structured by spousal love will mean that the norms governing human sexuality are not based on biological laws, but on the laws of love. Finally, Part II culminates in a reflection on the individual norms of sexual morality, showing how each of them follows the nature of spousal love. The precepts of the natural law are our guides to properly reverencing the sacred sphere of human sexuality, which is a condition for our flourishing as human persons.
Turbulence Ahead: Strategic Human Capital Management, Job Satisfaction, and Turnover Intention
Authors: Wesemann Andrew
Published: September 2023

The COVID-19 pandemic further illuminated the importance of strategic human capital management (SHCM). As the pandemic surged in the United States, employee retirement and resignation rates grew rapidly. Not surprisingly, the significant number of individuals seeking new employment opportunities or entirely exiting the labor force exacerbated human capital shortages that were already crippling public sector organizations. Fortunately, research has shown organizations that engage in SHCM initiatives can simultaneously enhance performance-related outcomes and successfully endure turbulent workforce conditions. Job satisfaction and employee turnover intention are two such outcomes that have received ample consideration among researchers. But while public sector scholarship has empirically demonstrated that SHCM influences employee job satisfaction, it has failed to adequately account for its indirect linkage to voluntary employee turnover. Therefore, using local government data collected biannually from 2016 to 2022, this study explicitly examines how endogeneity issues factor into the dynamic relationship between SHCM, job satisfaction, and turnover intention. The results of two-stage least squares regression analysis suggest that SHCM is indirectly related to employee turnover intention by way of employee job satisfaction.