bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from Spatial Dynamics of T- and B-Cell Responses Predicts Clinical Outcome of Resectable and Unresectable Hepatocellular Carcinoma
Authors: Kurebayashi Yutaka , Sugimoto Katsutoshi , Tsujikawa Hanako , Matsuda Kosuke , Nomura Rui , Ueno Akihisa , Masugi Yohei , Yamazaki Ken , Effendi Kathryn , Takeuchi Hirohito , Itoi Takao , Hasegawa Yasushi , Abe Yuta , Kitago Minoru , Ojima Hidenori , Sakamoto Michiie
Published: December 2024

AbstractPurpose:
Immunotherapies have led to a paradigm shift in the treatment of hepatocellular carcinoma (HCC). Studies have revealed the single-cell catalogs of tumor-infiltrating immune cells and the trajectories of their differentiation. Nevertheless, the spatial distribution of these immune cells with distinct phenotypes in the tumor microenvironment and their clinicopathologic significance in resectable and unresectable HCCs are still largely unclear.
Experimental Design:
We analyzed the spatial dynamics of intratumoral CD4 and CD8 T cells and their association with B and plasma cells using 283 surgically resected HCC samples, 58 unresectable HCC samples before combined immunotherapy [atezolizumab plus bevacizumab (Atezo + Bev)], and autopsy specimens from 50 cases of advanced-stage HCC through multiplex IHC combined with transcriptomic and driver gene mutation analyses. Classification based on the spatial dynamics of T- and B-cell responses (refined immunosubtype) was developed, and its clinicopathologic significance was analyzed.
Results:
We found that stem-like CD4 and CD8 T cells were mainly observed in T-cell aggregates and T-cell zone of tertiary lymphoid structure (TLS). The differentiation of T follicular helper cells was associated with the development of TLS, whereas the differentiation of CXCL13-expressing CD4 TCXCL13 cells with a phenotype resembling T peripheral helper cells was associated with the development of the lymphoplasmacytic microenvironment. The refined immunosubtype could predict clinical outcomes of resectable HCC after surgery and unresectable HCC after Atezo + Bev therapy. The immune microenvironment of metastatic lesions tended to reflect those of primary lesions.
Conclusions:
We revealed the spatial dynamics of T- and B-cell responses in HCC, which is closely associated with the clinical outcome after surgical resection or Atezo + Bev therapy.
Data from First-in-Human Dose-Escalation Study of the First-in-Class PDE3A–SLFN12 Complex Inducer BAY 2666605 in Patients with Advanced Solid Tumors Coexpressing SLFN12 and PDE3A
Authors: Papadopoulos Kyriakos P. , McKean Meredith , Goldoni Silvia , Genvresse Isabelle , Garrido Marine F. , Li Rui , Wilkinson Gary , Kneip Christoph , Yap Timothy A.
Published: December 2024

AbstractPurpose:
The study aims to evaluate the safety, tolerability, and pharmacokinetics of BAY 2666605, a velcrin that induces complex formation between the phosphodiesterase PDE3A and the protein Schlafen 12 (SLFN12), leading to a cytotoxic response in cancer cells.
Patients and Methods:
This was a first-in-human phase I study of BAY 2666605 (NCT04809805), an oral, potent first-in-class PDE3A–SLFN12 complex inducer, with reduced PDE3A inhibition. Adults with advanced solid tumors that coexpress SLFN12 and PDE3A received BAY 2666605 at escalating doses starting at 5 mg once daily in 28-day cycles. Forty-seven patients were prescreened for SLFN12 and PDE3A overexpression, and five biomarker-positive patients received ≥1 BAY 2666605 dose.
Results:
The most common adverse event was grade 3 to 4 thrombocytopenia in three of the five patients treated. The long half-life (>360 hours) and associated accumulation of BAY 2666605 led to the selection of an alternative schedule consisting of a loading dose with a once-daily maintenance dose. The maximum tolerated dose was not established as the highest doses of both schedules were intolerable. No objective responses were observed. Due to the high expression of PDE3A in platelets compared with tumor tissues, the ex vivo dose-dependent inhibitory effect of BAY 2666605 on megakaryocytes, and the pharmacokinetic profile of the compound, alternative schedules were not predicted to ameliorate the mechanism-based thrombocytopenia.
Conclusions:
Despite the decreased PDE3A enzymatic inhibition profile of BAY 2666605, the occurrence of thrombocytopenia in treated patients, an on-target effect of the compound, precluded the achievement of a therapeutic window, consequently leading to trial termination.
Data from Genomic Landscape of ctDNA and Real-World Outcomes in Advanced Endometrial Cancer
Authors: Soberanis Pina Pamela , Clemens Keelia , Bubie Adrian , Grant Brooke , Haynes Ginger , Zhang Nicole , Drusbosky Leylah , Lheureux Stephanie
Published: December 2024

AbstractPurpose:
ctDNA is a novel technique extensively studied in solid tumors, although not currently well defined in endometrial cancer.
Experimental Design:
A de-identified retrospective analysis of 1,988 patients with advanced/recurrent endometrial cancer was performed. In addition, an analysis of a real-world evidence cohort was completed (n = 1,266). Patients underwent ctDNA testing using Guardant360 during routine clinical care. The objective was to describe and assess molecular landscape using ctDNA.
Results:
Among 1,988 ctDNA samples, at least one somatic alteration was detected in 91.6% (n = 1,821). Most frequently altered genes were TP53 (64%), PIK3CA (29%), PTEN (25%), ARID1A (20%), and KRAS (14%). Overall, 18.5% had amplifications, with the majority identified in CCNE1 (40.9%), PIK3CA (22%), and EGFR (19.3%). From the real-world evidence cohort, those with TP53 mutations had a worse overall survival (OS) versus those without TP53 mutations (P = 0.02) and those with TP53 comutations had an inferior OS in comparison with TP53-mutated only (P = 0.016). Amongst these, patients with a PIK3CA comutation (P = 0.012) and CCNE1 amplification (P = 0.01) had an inferior OS compared with those with only TP53 mutations. Fifty-seven patients with newly diagnosed endometrial cancer had at least two serial ctDNA samples showing evolution in detected variants compared with baseline samples, with TP53 being the most frequent change.
Conclusions:
This study is one of the largest cohorts of ctDNA currently reported in endometrial cancer. The presence of TP53 mutation and other comutations detected by ctDNA have a negative effect on outcomes. This report suggests that ctDNA analysis is feasible and could become a useful biomarker for endometrial cancer.
Lack of consensus among stroke experts on the optimal blood pressure target of acute ischemic stroke: evidence from a national survey
Authors: Zhang Bing , Zhou Yihan , Zhang Xiaoxi , Li Yunke , Zhao Yang , Song Lili , Yang Pengfei , Zhang Yongwei , Liu Jianmin
Published: December 2024

Introduction: There remains a lack of consensus among physicians regarding the blood pressure management strategy for acute ischemic stroke patients, this study sought to determine current practice patterns and extension of consensus among stroke physicians after publications of several randomized controlled trials (RCTs).
Methods: An online survey of stroke clinicians registered to OCIN (Oriental Conference of Interventional Neurovascology) platform and ENCHANTED2/MT trial (Enhanced Control of Hypertension and Thrombectomy Stroke Study) collaborators was conducted to investigate the blood pressure management strategy after mechanical thrombectomy. The survey was sent out in March 2024, extracted within 1 month, and then analyzed comprehensively using descriptive statistics.
Results: 351 available responses were collected and analyzed. These participants mostly come from tertiary-level hospitals (90.6%) in 31 provinces in China. During mechanical thrombectomy (MT), the most popular blood pressure (BP) target was 140-160 mmHg (36.5%, 128/351) and 120-140 mmHg (26.8%, 94/351). For patients achieved successful reperfusion, those who achieved expanded treatment in cerebral infarction (eTICI) 3 were expected to maintain BP target of 120-140 mmHg (56.7%, 199/351) or <120 mmHg (27.1%, 95/351), while eTICI 2b were wished to 120-140 mmHg (45.3%, 159/351) or 140-160mmHg (38.5%, 135/351). For patients who achieved unsuccessful reperfusion, the most selected BP target was 140-160mmHg (40.7%, 143/351). In brief, Clinical doctors from China with different experiences have different views on the goals of BP management.
Conclusions: The survey highlights inter-institutional variability among stroke experts regarding the optimal BP target for acute ischemic stroke. While a majority of institutions have established standardized protocols for post-MT BP management, further prospective randomized trials are warranted to determine the optimal BP target.
Caffeine therapy for apnea of prematurity: single center study on dosing practices and perceived effectiveness
Authors: Storm Kelly K. , Flint Robert B. , Onland Wes , van Kaam Anton H. , Reiss Irwin K.M. , Hutten G. Jeroen , Simons Sinno H.P.
Published: December 2024

Introduction. Caffeine is the registered pharmacologic treatment for apnea of prematurity and is extensively used in the neonatal intensive care units (NICUs) based on evidence from randomized controlled trials. This study aimed to describe the clinical use of caffeine based on real-world data, hypothesizing a divergence from the registered dosing regimen.
Methods. A retrospective analysis included infants born before 30 weeks of gestation, admitted to the NICU of the Erasmus MC Rotterdam from 2018 to 2021. Exclusion criteria comprised infants admitted after postnatal day 2, those not receiving caffeine during admission, patients admitted for less than 24 hours, those who spent less than 24 hours on non-invasive support, and cases lacking medication data. The primary outcome was the proportion of patients receiving an average caffeine dose higher than registered in the label.
Results. A total of 451 patients with a median gestational age of 28+0 weeks (IQR 26+2-29+0) and birthweight of 1,015 grams (IQR 800-1,218) were included. Of these, 402 infants (89%) received an average daily caffeine dosage exceeding the registered dose range. The median caffeine maintenance dose per patient was 5.3 mg/kg/day (IQR 5.0-5.8), with additional therapy (mini-load, doxapram or intubation) needed in 318 patients (71%).
Conclusion. This study highlights the frequent use of higher caffeine dosages in clinical practice than registered and recommended based on long-term safety data. Despite these high dosages and frequent mini-loads, 28% of patients still required additional treatment with doxapram and/or invasive mechanical ventilation, indicating the need for individualized dosing strategies or alternative therapies.
Outcome after Intraoperative Ejection of Descemet Membrane Endothelial Keratoplasty Graft: A Case Report
Authors: Sood Kishan S. , Ma Kevin K. , Yu Charles Q.
Published: December 2024

Introduction: There is no data on management of intraoperative ejection of a Descemet membrane endothelial keratoplasty (DMEK) graft. We report a case of graft survival after intraoperative ejection with long-term endothelial cell counts and vision. Case Presentation: A 64-year-old woman with Fuchs corneal dystrophy underwent DMEK in the right eye, during which the graft was completed ejected from the eye, and then recovered and reinjected successfully. She subsequently also underwent DMEK in the left eye without complication. The patient had recovery of vision in both eyes to 20/20 shortly after each surgery. There was much greater loss of endothelial cells in the eye which experienced graft ejection than the eye with routine DMEK surgery (79% vs 44%). Conclusions: Our results support attempt to recover ejected DMEK graft if conditions are appropriate, but also show that there will be increased loss of endothelial cells as compared to routine surgery.
Integracija psihološke skrbi u zdravstvenu praksu
Authors: Čupić Marija , Zoranić Sanja , Iveta Vedrana
Published: December 2024

Uvod: U suvremenom zdravstvenom sustavu integracija psihološke skrbi u zdravstvenu praksu postaje sve važnija zbog njezina utjecaja na cjelokupno zdravlje pacijenata. Psihološka skrb, koja uključuje emocionalnu, mentalnu i socijalnu podršku, pokazuje značajan potencijal u poboljšanju zdravstvenih ishoda i kvalitete života pacijenata.Metode: Istraživanje je provedeno analizom relevantne literature, slučajnih studija i pregledom postojećih modela integracije psihološke skrbi u različite aspekte zdravstvene skrbi. Korišteni su izvori kao što su istraživački članci, izvještaji te prakse u bolnicama/klinikama koje primjenjuju holistički pristup u brizi o pacijentima te pristup skrbi usmjerene na pacijenta.Rezultati: Analizom je utvrđeno da integracija psihološke skrbi u zdravstvenu praksu poboljšava ishode liječenja, smanjuje nivo stresa i anksioznosti pacijenata te doprinosi bržem oporavku. Specifični primjeri uključuju poboljšanje kvalitete života kod pacijenata s kroničnim bolestima i bolje upravljanje emocionalnim reakcijama kod onkoloških pacijenata. Studije slučajeva potvrđuju da pacijenti koji su imali psihološku skrb imaju bolju kvalitetu života i brži oporavak u usporedbi s onima koji je nisu imali. Također, analiza je pokazala da integracija može smanjiti uporabu lijekova i potrebu za hospitalizacijom.Zaključak: Psihološka se skrb pokazuje kao ključna komponenta u holističkom pristupu zdravstvenoj njezi. Kako bi se maksimizirale koristi integracije psihološke skrbi, neophodna je adekvatna edukacija zdravstvenih radnika, smanjenje stigma vezanih za mentalno zdravlje i bolja koordinacija između različitih sektora zdravstvene zaštite. Ovaj rad ističe potrebu za daljnjim istraživanjima i razvojem politika koje će omogućiti efikasniju integraciju psihološke skrbi u svakodnevnu praksu.
Povezanost demografskih značajki, razine straha i postoperativnog tijeka kod traumatoloških bolesnika
Authors: Palatinuš Dinka , Teresa Galinec Beata
Published: December 2024

Uvod: Traumatološki bolesnici s akutnim traumama prvi su put hospitalizirani na Odjel traumatologije putem Hitne kirurške ambulante u kojoj se indicira prijem. Većinom su to prijelomi u području kuka, bedrene kosti, potkoljenice te gornjih ekstremiteta, a u nekim slučajevima prisutne su i višestruke ozljede.Cilj: Cilj je rada usporediti povezanost demografskih značajki s razinom straha prije hitne operacije i postoperativnog tijeka.Ispitanici i metode: Istraživanje je uključilo 100 hospitaliziranih hitnih traumatoloških bolesnika Kliničke bolnice Sveti Duh u razdoblju od 3. prosinca 2018. do 1. lipnja 2019. Podatke smo prikupljali prospektivno, anketnim upitnikom, medicinskom dokumentacijom te sestrinskom anamnezom. Strah kao promatrana varijabla mjeren je upitnikom procjene straha od operacije (engl. Surgical Fear Questionnaire in adult patients, SFQ).Rezultati: U istraživanju umirovljenici predstavljaju veći dio anketirane populacije. Većina ispitanika već je prethodno imala operacijske zahvate i komplikacije liječenja. Ispitanici su se najviše bojali dugotrajne rehabilitacije i boli nakon operacije. Također je zabilježena velika briga za obitelj kod pacijenata. Žene su pokazale manju prosječnu razinu straha od muškaraca. Dob ispitanika nije povezana s razinom straha. Trajanje hospitalizacije i broj dana potrebnih za samostalno ustajanje iz kreveta međusobno su pozitivno korelirani. Koeficijent korelacije pokazuje vrlo slabu, no ipak statistički značajnu pozitivnu povezanost između ocjene boli po dolasku u bolnicu i trajanja hospitalizacije.Zaključak: Prema dobivenim rezultatima može se zaključiti da ukupan prosječan strah ispitanika nije bio značajno povezan s promatranim varijablama. Težina zahvata i strah u međusobnoj su slaboj korelaciji. Najveća je povezanost vidljiva između straha od operacije i straha od anestezije.
Utilizing tACS to enhance memory confidence and EEG to predict individual differences in brain stimulation efficacy
Authors: Wynn Syanah C. , Marshall Tom R. , Nyhus Erika
Published: December 2024

The information transfer necessary for successful memory retrieval is believed to be mediated by theta and gamma oscillations. These oscillations have been linked to memory processes in electrophysiological studies, which were correlational in nature. In the current study, we used transcranial alternating current stimulation (tACS) to externally modulate brain oscillations to examine its direct effects on memory performance. Participants received sham, theta (4 Hz), and gamma (50 Hz) tACS over frontoparietal regions while retrieving information in a source memory paradigm. Linear regression models were used to investigate the direct effects of oscillatory noninvasive brain stimulation (NIBS) on memory accuracy and confidence. Our results indicate that both theta and gamma tACS altered memory confidence. Specifically, theta tACS seemed to lower the threshold for confidence in retrieved information, while gamma tACS appeared to alter the memory confidence bias. Furthermore, the individual differences in tACS effects could be predicted from electroencephalogram (EEG) measures recorded prior to stimulation, suggesting that EEG could be a useful tool for predicting individual variability in the efficacy of NIBS.
Challenges in measuring individual differences of brain function
Authors: Xu Ting , Kiar Gregory , Zuo Xi-Nian , Vogelstein Joshua T. , Milham Michael P.
Published: December 2024

With a growing interest in personalized medicine, functional neuroimaging research has recently shifted focus from the evaluation of group-level summaries to associating individual differences in brain function with behaviors. However, this new focus brings forth challenges related to accurately measuring the sources of individual variation in functional signals. In this perspective, we highlight the impact of within-individual variations and discuss the concept of measurement reliability as a critical tool for accounting for within- and between-individual variations when measuring individual differences in brain function.
Cordyceps duyunensis, a new species from Doupeng Mount, Guizhou, China
Authors: LI DAN , CHEN WAN-HAO , SHU HUI-LIN , TIAN XIAO-LI , LIANG JIAN-DONG , HAN YAN-FENG
Published: December 2024

A new species, Cordyceps duyunensis, which was isolated from an infected pupa, is introduced. Morphological comparisons and phylogenies analysis of a multigene dataset (SSU, ITS, RPB1, RPB2 and TEF) support the establishment of the new species. It differs from related species by its smaller phialides.
Rice Seed System: Current Practices to Strengthen Early Generation Seed of Climate Resilient Rice Varieties in Ethiopia
Authors: Assaye Yilikal , Gashu Ayele , Tenaw Esuyawkal
Published: December 2024

The availability of quality rice seed is a critical factor in boosting rice productivity and production in Ethiopia. This study assessed the current practices of early generation and community-based rice seed multiplication and quality control to strengthen the rice seed system in Fogera district, Ethiopia. Community-based seed production and marketing groups played a significant role in rice seed multiplication and distribution, but faced challenges related to limited access to breeder and foundation seed, inadequate technical and financial support, and weak seed quality control mechanisms. Strengthening the capacity of seed producers, enhancing the availability of early generation seed, and improving seed quality assurance systems are recommended to enhance the effectiveness of the rice seed system in the study area. Intervention of large scale demonstration of the early generation rice seed is one of the practical and effective techniques in the rice seed system, which can enhance the better rice seed accessibility. Large scale demonstration of early generation rice seed is also useful for participatory learning on the rice seed production procedures, and rice seed quality management activities in the community. The findings provide insights for policymakers and development practitioners to design and implement interventions that can strengthen community-based rice seed systems in Ethiopia.
Delirium in Adult Critical Care Unit: Prevalence and Outcomes at Regional Hospital
Authors: Mahrouqi Basma , Namani Huda , Harmali Zaina , Sulaimi Fadi , Shibani Aliya
Published: December 2024

Background: Delirium is an acute confusional state that affects 30-80% of admitted patients to intensive care units. According to the literature, delirium may worsen patients’ and hospital outcomes. No research studies regarding delirium prevalence and outcomes were found in Oman. Objective: This study aims to determine the prevalence and outcomes of delirium in Adult patients admitted to the Intensive Care Unit (ICU) at a regional hospital. Methodology: This study followed an observational longitudinal design. A consecutive sampling method for six months was used for selecting Adult Intensive Care Unit (AICU) patients after 48 hours of ICU admission and a total of 76 patients aged 18 years and older were included. Confusion Assessment Method in Intensive Care Unit (CAM-ICU) instrument (CAM-ICU worksheet and Daily Assessment Checklist) was used for assessing patients’ prevalence and outcomes of delirium. A training program was provided for adult intensive care doctors and nurses regarding using the CAM-ICU tool one month before the study. Social Packages for the Social Sciences Program (SPSS) version 20 was used for data analysis. Results: More than half of the participants were male (63%), while the age group above 65 years (42%) had more positive cases. Results indicated a high prevalence of delirium in AICU (77%) of admitted patients. Outcomes of delirium in AICU indicated two outcomes, duration in AICU and ventilation days. Duration in ICU (M= 15.53, SD= 21.27) while ventilation days indicated a (M=13.30, SD=20.69). The result indicated a significant positive relationship between age, duration days in ICU, and ventilation days to delirium (p=0.001). Conclusion: The results from this study indicated a high prevalence of delirium in AICU and delirium is associated with longer duration in AICU and longer ventilation days. Identifying delirium prevalence and outcomes can enhance the early management of delirium and improve patients’ and hospital outcomes. In addition, results from this study can improve the knowledge and skills of healthcare providers in using the CAM-ICU assessment as a valid tool for assessing delirium in Intensive care unit (ICU) patients.
Prevalence of Helicobacter Pylori Among Patients with Chronic Gastritis in Nigeria
Authors: Ewa Adamu , Abdulkadir Yussuf , Ibrahim Yusuf
Published: December 2024

Introduction: The stomach wall is made up of smooth muscles which are arranged in three layers: outer longitudinal, inner circular and innermost oblique layers. The mucosa is made up of simple columnar epithelium and is made up of several cell types which include: mucous cells which secrete alkaline mucous that protects the epithelium against acid and shear stress. Gastritis can involve the whole of the stomach, or a specific part of the stomach such as the fundus, body or the antrum and the distribution of gastritis may be related to an aetiologic factor. H. pylori causes passive inflammation inside the gastric epithelium and alters signal transduction pathways that serve as a platform for the pathogenesis, but it also develops antimicrobial resistance via genetic changes and biofilm development. The bacterium floats in the direction of the epithelial membrane when it enters the stomach, taking advantage of areas of the stomach wall that are injured. Method: The study was conducted in Kano, Nigeria from April 2021 to October 2021 and it is a Hospital-based Cross-sectional Descriptive study. Patients with dyspepsia referred for oesophagogastroduodenoscopy (OGD) at the endoscopy suite of the hospital constitute the study population, 197 patients that met the inclusion criteria were recruited and underwent OGD. Each patient were biopsied in accordance with the updated Sydney protocol. Data were collected and the report of both endoscopy and histological assessment for the presence of gastritis and H. pylori were documented and analyzed using the SPSS 20. Result: H. pylori was detected in 137 patients out of the 197 gastric biopsies sample of gastritis, the prevalence was 69.5%. Also, There was a statistically significant relationship between H. pylori and those aged 31-40years (p = 0.025), however, the relationship was not significant for the other age groups and no significant relationship was found between sex (p = 0.512). The most common site affected by histologic gastritis in this study was the antrum (99.4%) and the high predominance of antral involvement is probably due to the high rate of H. pylori infection in the study subjects which is known to be associated with antral affectation. Conclusion: The most predominant pattern of histologic gastritis was chronic H. pylori gastritis located in the antrum. The prevalence of H. pylori infection was 69.5%, and it had significant association with both endoscopic and histologic gastritis. Therefore, prevention and eradication program for the H. pylori infection are necessary in our environment.
An Asymmetric Model of the Tropical Cyclone Surface Wind Field and Probabilistic Climatology of Structural Parameters
Authors: Uhlhorn Eric W. , Tolwinski-Ward Suz , Lorsolo Sylvie
Published: December 2024

A new parametric model of a tropical cyclone’s (TC) surface wind field is proposed, in which parameters are calibrated on over 20 years of direct surface wind measurements from aircraft reconnaissance. The model extends previous formulations by representing structural asymmetries in the inner core and far field. The surface wind representation eliminates the need for uncertain aircraft flight (gradient) level-to-surface extrapolation or pressure gradient formulation conversions to wind speed. Parameters are expanded to wavenumber-1 asymmetric Fourier components around symmetric mean values; symmetric values are found to depend primarily on maximum wind speed and geographic location, while some asymmetric parameters show statistically significant relationships with motion and environmental vertical shear, consistent with recent studies. Finally, a probabilistic representation of the climatology of basin-wide TC wind field structure is constructed by fitting a multivariate statistical distribution to the optimized model parameters. The low-dimensional formulation is suitable for computationally efficient reconstruction of historical TC wind fields, from depression to Saffir–Simpson category-5 intensities, as well as for stochastic simulation in the context of catastrophe risk modeling.
Symmetric Non-Monochromatic Light as Reference in Fourier Transform Spectrometers
Authors: Wen Muqian
Published: December 2024

Fourier transform spectrometers typically use a presumed monochromatic reference source to track and correct errors in optical path difference changes. This paper will conduct a theoretical analysis to show that non-monochromatic light sources with symmetric spectral profiles can also be used as reference sources without adding errors. An experiment was carried out using a symmetric broadband superluminescent diode (SLED) as reference light to measure the spectrum of some other SLED light sources to experimentally demonstrate this finding.
The Six-Factor Cognitive Domino Model of Anxiety
Authors: Tang Yonglong , Gan Nina , Yang Hongmian
Published: December 2024

Although humans have been exploring the mysteries of anxiety, relatively few specific cognitive pathways for generation of anxiety have been explored. We integrated many existing theories and experiences in clinical counseling to propose a new anxiety cognitive domino model of anxiety. The model suggests that there are six ordered cognitive factors that affect anxiety, which act like a domino effect, leading to the development and circulation of anxiety. On the one hand, this model provides a more comprehensive framework for understanding anxiety from the perspective of assessing abilities at different psychological stages. On the other hand, this model explores methods for pre managing anxiety before stressful events occur, which has practical significance for both individuals and organizations.
Critical Autoethnographic Narrative for Language Teacher Identity Development
Authors: Hauber-Özer Melissa , Beketova Zhanar , Wang Sylvia (Siya)
Published: December 2024

English language teacher education requires a shift from a solely skills-based approach to one that addresses identity development and prepares teacher-learners to engage with issues of identity in the classroom. This article demonstrates the use of a critical autoethnographic narrative (CAN) assignment (adapted from Yazan, 2019) to foster language teacher identity development around these issues as a foundation for pedagogical praxis. The CAN assignment was developed for a sociolinguistics in education course required as part of a master’s degree program in educational linguistics, which enrolls primarily international students, at a prestigious private university in the northeastern United States. Authored by the instructor and two teacher-learners who were enrolled in the course, the article provides an overview of the course structure and key readings as well as prompts for a series of five short memos intended to stimulate reflection on and application of course topics, which included language varieties, speech communities, language ideologies, gender and sexuality, globalization, English as a Lingua Franca/World Englishes, and native-speakerism, to their own language-related experiences, identities, beliefs, and practices. At the conclusion of the semester, students compiled their memos into cohesive first-person narratives with references to the texts which influenced their thinking. Based on completed narratives and teacher-learner feedback, the CAN assignment achieved the goal of fostering critical reflection on sociolinguistic aspects of English language learning and teaching. Taking an autoethnographic approach in line with the assignment, the article includes excerpts from teacher-learners’ memos and CAN papers examining the roles that various languages have played in their personal and professional development and the connections between social environment, language, and identity. The article closes with recommendations for implementation of the assignment to foster awareness and foster practical application of sociolinguistic concepts.
To Honor and Defend: State- and Individual-Level Analyses of the Relationship Between the U.S. Culture of Honor and Military Service
Authors: Bock Jarrod E. , Brown Ryan P. , Tucker Raymond P. , Foster Stephen D.
Published: December 2024

Understanding the factors that explain why some people are more likely to enlist in military service is an important endeavor for any nation that depends upon a voluntary military force. Three studies investigated the role of honor culture in military service. These studies assessed statewide differences in military enlistment rates (Study 1), individual differences in honor endorsement between military personnel and civilians (Study 2), and associations between honor endorsement and facets of military identification in a sample of active-duty Army personnel (Study 3). Results showed that honor was strongly and consistently associated with military service, independent of a wide range of potential confounds (e.g., economic precariousness, rurality, gender, age, and military rank). This research extends previous studies on the honor-military service link and has potentially important implications for military recruitment strategies and for our understanding of why military service might be a risk factor for subsequent mental health problems.
Coping With Competing Role Expectations: How Do Independent Directors Make Sense of Their Role?
Authors: Yamada Jin-ichiro , Yoshikawa Toru
Published: December 2024

How do individual independent directors make sense of their director role? We examine this question in the context of competing expectations among key corporate governance actors during the onboarding process of independent directors. This study explores how independent directors navigate these expectations, which stem from both external change agents, such as government agencies and the media, and internal actors, especially management. Given the inherent ambiguity of their roles, which involve multiple board tasks and lack explicit definition, independent directors often face role conflicts. Our findings reveal that independent directors resolve these conflicts by adopting one of three role orientations: external adaptive, organizational alignment, or provisional balancing. Through this process, they construct their director role by coping with the expectations of key governance actors. This study contributes to the micro-foundations of corporate governance research by shedding light on the individual-level dynamics that shape how independent directors interpret and enact their roles.
Seal of Approval? Trust signals and cultural distance in a global peer-to-peer platform market
Authors: Bird Yanhua
Published: December 2024

Trust is essential for fostering cooperation, especially in global peer-to-peer platform markets where transactions between strangers involve significant risks and uncertainties. The global scope of these platforms introduces cultural differences, further intensifying these challenges. It is well established that social distance shapes trust, with decision-makers typically favoring those who share similarities, leading to trust disparities that advantage some participants while disadvantaging others. But existing theories offer conflicting perspectives on whether quality signals can bridge or exacerbate the gap between advantaged (i.e., socially proximate to focal decision-makers) and disadvantaged (i.e., socially distant from focal decision-makers) participants. Drawing on sociological theories of trust production that highlight how various social systems act as different sources of trust, we offer a new perspective to this puzzle by comparing two types of quality signals: reputation, which is derived from prior exchanges and provided by prior exchange partners, and institutional accreditation, which is linked to organizational institutions. Analyzing a proprietary dataset from a global peer-to-peer lodging platform, we find that prospective guests who are more culturally distant from hosts are in a disadvantaged position: their lodging requests are less likely to be approved by hosts. Furthermore, the positive effect of guest reputation (i.e., ratings) is weaker for culturally distant guests, and thus widens the gap in host acceptance of culturally proximate versus culturally distant guests. By contrast, the positive effect of institutional accreditation (i.e., platform verification) is stronger for culturally distant guests, indicating that it helps narrow the gap. These findings reveal unexplored contingencies to theories of evaluations bias and discrimination, contributing to the broader literature on trust, culture, and inequality in global online markets, and underscoring the challenges of building trust in uncertain environments.
Early experience managing intravascular coagulum using polidocanol endovenous microfoam: Risk factor analysis
Authors: Mesa-Damiano Mariam , Melesio Francisco J , Quiñones-Rodriguez Jailenne I , Malgor Rafael D , Rodriguez Limael E
Published: December 2024

Objective

A single-center retrospective cohort study was conducted to identify potential risk factors that lead to increased incidence of intravascular coagulum (IC) observed in clinical practice using polidocanol endovenous microfoam (PEM 1%, VarithenaTM [polidocanol injectable microfoam], Boston Scientific, Marlborough, Mass).

Methods

Patients ( n = 119) who received polidocanol endovenous microfoam (PEM) treatment for chronic venous insufficiency between December 2021 and January 2024 at a private outpatient vascular surgery clinic were observed to identify potential risk factors in the development of IC. The patients were stratified into two groups: IC ( n = 16) versus non-IC ( n = 103). Patients who returned with increased pain and irritation at the treatment site in the early post ablation period within 2-6 weeks of treatment and had coagulum aspirated at the subsequent follow-up visit met the study criteria and were included in the IC group. In addition, patient demographics, comorbidities, and duplex ultrasound reports were analyzed using deidentified chart records.

Results

There were 119 patients treated in the study period with a mean age of 62 years. Females were the most common sex 66% ( n = 78) and Latinos represented the largest ethnicity 60% ( n = 71). Overall, 13% ( n = 16) of the patients developed an intravascular coagulum. The mean time to onset of IC was 45 days (range: 7-106 days) post-ablation. There was no difference between the groups (IC vs non-IC) for age, sex, ethnicity, or index VCSS scores. On univariate analysis, patients who developed IC had lower PEM injection volumes when compared to non-IC patients (4.1 vs 6.3 mL, p = .04). High reflux at the GSV (>1800 ms) and Latino ethnicity were also found to be significant risk factors. When these factors were evaluated in multivariate analysis, lower PEM injection volumes was the only factor that remained significant for the development of IC ( p = .006).

Conclusion

Lower polidocanol endovenous microfoam injection volumes is a risk factor for developing intravascular coagulum. Further studies are needed to identify the ideal injection volume per segment of vein treated.
Correlation analysis of serum inflammatory cytokine levels and immune markers in children with severe hand, foot and mouth disease
Authors: Li Xiao , Zhou Qian
Published: December 2024

Objective

To identify the correlation between serum inflammatory cytokines and immune markers in children with severe hand, foot and mouth disease (HFMD).

Methods

Paediatric patients with severe or mild HFMD from Linping Campus, the Second Affiliated Hospital of Zhejiang University, were included in this retrospective study. Data comprising demographic characteristics, clinical symptoms and signs, laboratory findings and other factors were collected. Serum interleukin (IL)-1, IL-6, IL-10, tumour necrosis factor (TNF)-α, and interferon (IFN)-γ levels were measured by enzyme-linked immunosorbent assay at 1, 3, and 5 days after admission. Risk factors were screened using multivariate logistic regression analysis.

Results

A total of 200 patients with HFMD (120 severe and 80 mild cases) were included. Younger age and longer fever duration were associated with severe HFMD, as were increased white blood cell, neutrophil and platelet counts, blood glucose, immunoglobulin (Ig)M and IgG. IL-6 and IL-10 levels were higher in patients with severe versus mild HFMD on days 1, 3 and 5. TNF-α was higher in the severe group on day 3. Increased white blood cell and neutrophil counts, IL-6, IL-10, and IgG levels, age, fever duration, and blood glucose level were found to be risk factors associated with the occurrence of severe HFMD.

Conclusions

Inflammatory cytokines and immune indexes may be related to the occurrence of severe HFMD.
Success rate of acceleromyographic neuromuscular monitoring based on the depth of anesthesia at the time of sugammadex antagonism: a randomized controlled trial
Authors: You Hwang-Ju , Lee Seok-Jin , Jung Ji-Yoon , Cho Sung-Ae , Kwon Woojin , Kim Jin-Bum , Sung Tae-Yun
Published: December 2024

Objective

We aimed to compare the success of non-normalized acceleromyographic neuromuscular monitoring and recovery profiles based on the depth of anesthesia at the time of sugammadex administration.

Methods

Patients undergoing general anesthesia were prospectively and randomly allocated to two groups. In the BIS60 group, sugammadex was administered when there was a bispectral index (BIS) <60 and anesthesia was maintained until a train-of-four ratio ≥1.0 was obtained, whereas in the BIS70 group, anesthesia was stopped at the completion of surgery, sugammadex was administered when the BIS was >70, and the recovery of neuromuscular function was monitored. The recovery profile and the incidence of emergence agitation of the two groups were compared.

Results

The success rate of neuromuscular monitoring was significantly higher for the BIS60 group than for the BIS70 group (100% vs. 37.5%, respectively). The time taken for recovery for the two groups was comparable. The incidence of emergence agitation was significantly lower in the BIS60 group than in the BIS70 group (23.3% vs. 56.3%, respectively).

Conclusion

After the administration of sugammadex, the maintenance of anesthesia until the full recovery of neuromuscular function increases the success rate of neuromuscular monitoring without delaying recovery and reduces the risk of emergence agitation. Clinical trial registration: CRIS registration number KCT0007899 ( https://cris.nih.go.kr/ )
Representation, Nonprofit Leaders of Color, and Job Attraction: A Survey Experiment
Authors: Li Bo , Kim Mirae
Published: December 2024

Research has shown that nonprofits led by people of color (POC) tend to have more diverse staff compared to White-led organizations, yet it remains unclear whether leaders of color inherently attract racially diverse talent. Using an online experiment, this study investigates the impact of the racial/ethnic composition of nonprofit leadership on job-seeking behaviors. While participants consistently view POC-led nonprofits as more committed to diversity, this positive perception does not influence their job choices. When given a choice, White individuals tend to prefer working for White-led nonprofits, whereas people of color show no strong preference between POC-led and White-led nonprofits. The results shed light on the complexities of racial representation in talent acquisition, offering important insights into the broader discourse on nonprofit diversity and the persistent barriers POC-led organizations face in achieving diverse staffing.
Neonatal lupus erythematosus: 24 years of experience from a tertiary centre at Chandigarh, North India
Authors: Pilania Rakesh Kumar , Thangaraj Abarna , Sil Archan , Dhaliwal Manpreet , Sharma Saniya , Jindal Ankur Kumar , Vignesh Pandiarajan , Garg Ravinder , Aggarwal Pankaj , Kumar Rupesh , Naganur Sanjeev , Rawat Amit , Suri Deepti
Published: December 2024

Objective

To study the clinical features and laboratory parameters of neonatal lupus erythematosus (NLE) from India.

Patients and methods

We analyzed case records of children diagnosed with NLE in the Pediatric Rheumatology Clinic at tertiary care centre from North India during the period January 1999 - December 2023.

Results

Twenty-four babies are diagnosed with NLE during the study period. Median age at diagnosis was 60 days with a female predisposition (Male to female- 1:2). Cutaneous manifestations were reported in 14 (58%) patients. Hepatomegaly was noted in 15 (62.5%), and splenomegaly in 2 (8%). Elevated transaminases were noted in 14 (58%) patients, and cholestatic jaundice in one. Hematological manifestations were noticed in 20 (83.3%), and neurological manifestations were noticed in 8 patients. Most non-cardiac manifestations were self-limiting. Intravenous immunoglobulin was used for phrenic nerve palsy and autoimmune hemolytic anemia. Oral corticosteroid was used in a patient with refractory cytopenia, and four patients required transfusions. Cardiac involvement was reported in 13 (54%) patients – 3rd-degree heart block in 9 patients, and 6 were managed with epicardial pacemaker insertion. One patient required pacemaker reimplantation due to infective endocarditis. Congenital hydrops was seen in 3 patients, and required respiratory support and recovery was uneventful.

Conclusion

NLE is associated with significant morbidity. More than half had cardiac manifestation, of which 70% had 3rd-degree heart block requiring pacemaker insertion. Other rare clinical manifestations like phrenic nerve palsy and seizures are noticed in our cohort.
Sir Nicholas Gilbourne's (magical) cross-over trial of 1631
Authors: Cooper Max , Cooper Sarah
Published: December 2024

We describe a basic ‘cross-over’ trial undertaken by Sir Nicholas Gilbourne of Kent, England, in or before 1631. This was used to test the effectiveness of ‘weapon salve’, an ointment claimed to cure ‘sympathetically’ (i.e. remotely) by application to the weapon that inflicted an injury. Gilbourne reports very basic outcomes but these represent key stages of a modern cross-over trial: no treatment, treatment, no treatment, treatment. We discuss the value of such historical vignettes – even a magical one – for medical students in two respects: understanding research methodology and learning about consultation strategies. Gilbourne's conclusion is clearly fanciful but the basic principles behind his experiment are sound. Historical examples like this can inspire medical students to think critically about research methods and treatment strategies.
Emerging Dilemmas in the Age of Resistance: The Case of Sexually Transmitted Infections
Authors: Chandra Shiva , Broom Alex , Peterie Michelle , Ridge Damien , Kenny Katherine , Lafferty Lise , Treloar Carla , Applegate Tanya , Broom Jennifer
Published: December 2024

The stage is set for a new era of precariousness in modern medicine, driven by the increasing failure of a key pharmaceutical pillar—antimicrobials. In the context of sexually transmitted infections (STIs), the rise of antimicrobial resistance is introducing urgent questions around what might constitute “best practice” in a rapidly evolving scene, including the value of asymptomatic screening (test and treat), and the consequent downstream collateral damage emerging from over-use of our diminishingly effective antimicrobial resources. Drawing on interviews with clinicians, experts, and industry representatives, we examine resistance as a site of emerging and co-constitutive moral, temporal, and economic dilemmas. Such dilemmas, as illustrated in participants’ accounts, involve complexities regarding prioritization between competing health demands; doing good work while meeting business requirements; considering trade-offs between visibility and amplifying the problem; difficulties balancing presents and futures; reconciling divergent clinical opinions and expertise; and managing patient subjectivities, while considering the implications of clinical practices for resistance. Importantly, centering dilemmas in context of antibiotic-resistant STIs open greater theoretical scope to consider the challenging spaces that key actors such as clinicians and decision-makers occupy, as they attempt to curb resistance while caring for individuals and the community.
Beyond the deepfake problem: Benefits, risks and regulation of generative AI screen technologies
Authors: Broinowski Anna , Martin Fiona R.
Published: December 2024

Australian debates about how to regulate deepfake video have, to date, largely been shaped by STEM agendas for generative artificial intelligence (AI) policy and public fears about disinformation intensification. As the federal government consults on AI regulation, this article aims to move policymakers’ focus beyond the deepfake ‘problem’ to investigate the implications of generative AI screen technologies from two creative industries perspectives. First, it establishes the negative and positive uses of deepfake applications in media, politics, commerce, education, film and art. Second, it compares the forms and scope of emerging international deepfake regulations with those proposed in Australia to conceptualise the impact that restrictions on deepfakes might have for domestic screen producers, flagging the potential closure of artistic and public expression. In doing so, we highlight that a STEM-focused approach to deepfake regulation is insufficiently attuned to the benefits of synthetic media applications in the post-truth AI communications economy.