bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-genderism in the Spanish radical right’s propaganda discourses
Authors: Rebollo-Bueno Sara
Published: October 2024

Anti-genderism discourses emerge in response to new public policies resulting from the Fourth Feminist Wave. In
the case of Spain, the radical right political party Vox not only articulates an anti-genderism discourse but has also proposed
the so-called Parental Pin as an alternative to feminist education. In this light, this study aims to analyse
the propagandistic messages of the aforementioned party on social networks, focusing on the Parental Pin as the
main theme. Furthermore, it examines the favourable feedback received from its followers. The application of Critical Discourse
Analysis revealed that polarisation constitutes a fundamental resource for understanding the communicative and political
strategy of the party. Results also revealed that the party conveys an image of itself as guardians of parental freedom and
national values, while strategically portraying the left and feminists as adversaries.
The Bilingual Dual-path model
Authors: Khoe Yung Han , Frank Stefan L.
Published: October 2024

Experimental research has yielded many important psycholinguistic findings in bi-/multilingualism. However,
cognitive computational models of sentence processing were limited to the single-language case until recently. In this
methodological review, we discuss cognitive modelling work that uses the Bilingual Dual-path model to simulate experimental
research on bilingual sentence production, processing, and development. As a detailed example of such work, we then report on new
simulations conducted with the model. Finally, we suggest directions for future cognitive modelling research using this model.
Density fluctuation statistics and turbulence spreading at the edge of L–mode plasmas
Authors: Khabanov F.O. , Hong R. , Diamond P. H. , Tynan G. R. , Yan Z. , McKee G. R. , Chrystal C. , Scotti F. , Yu G. , Zamperini S. A. , Zhu Y.
Published: October 2024

Long-wavelength density fluctuations (

k

ρ
i

<1) are studied using beam emission spectroscopy (BES) at the edge of DIII-D L-mode plasmas (

ρ

= 0.88–1.1) in scenarios with electron cyclotron heating (ECH) power ramp (

P

ECH

up to 1.5 MW), neutral beam injection (NBI) power ramp (

P

NBI

up to 2.5 MW), and injected torque scan (−1 <

T

inj

<0.6 Nm). We find that broadband turbulent density fluctuations (

f

∼ 20–120 kHz) have a non-Gaussian distribution. The skewness of

δ
n

/

n

changes sign from negative at

ρ

<0.95–0.97 to positive at

ρ

> 0.97, indicating the prevalence of density ‘voids’ at inner radii and density ‘blobs’ at outer radii and outside of the separatrix. The turbulence intensity flux

⟨

v
~

r

n
~

2

⟩

is calculated to characterize turbulence spreading at the plasma edge. During ECH/NBI power ramps and at counter-

I

p

injected torque,

⟨

v
~

r

n
~

2

⟩

is directed inward inside the separatrix, which is evidence of inward spreading of turbulence intensity from the edge gradient region caused by the inner propagation of density ‘voids’. Significantly weaker

⟨

v
~

r

n
~

2

⟩

is observed with co-

I

p

torque. A correlation between co-

I

p

torque, turbulence intensity

δ
n

/

n

at

ρ

= 0.97, and increased srape-off layer (SOL) heat flux decay length

λ
q

is found in the torque scan scenario, showing that edge turbulence plays a material role in determining the SOL conditions and heat flux width.
Isotopic seasonality of fluvial-derived greenhouse gases implies active layer deepening
Authors: Schwab Melissa S , Elder Clayton D , Xu Xiaomei , Czimczik Claudia I , Miller Charles E
Published: October 2024

Climate change in the northern circumpolar regions is rapidly thawing organic-rich permafrost soils, leading to the substantial release of dissolved CO2 and CH4 into river systems. This mobilization impacts local ecosystems and regional climate feedback loops, playing a crucial role in the Arctic carbon cycle. Here, we analyze the stable carbon (δ
13C) and radiocarbon (F14C) isotopic compositions of dissolved CO2 and CH4 in the Sagavanirktok and Kuparuk River watersheds on the North Slope, Alaska. By examining spatial and seasonal variations in these isotopic signatures, we identify patterns of carbon release and transport across the river continuum. We find consistent CO2 isotopic values along the geomorphological gradient, reflecting a mixture of geogenic and biogenic sources integrated throughout the watershed. Bayesian mixing models further demonstrate a systematic depletion in 13C and 14C signatures of dissolved CO2 sources from spring to fall, indicating increasing contributions of aged carbon as the active layer deepens. This seasonal deepening allows percolating groundwater to access deeper, older soil horizons, transporting CO2 produced by aerobic and anaerobic soil respiration to streams and rivers. In contrast, we observe no clear relationships between the 13C and 14C compositions of dissolved CH4 and landscape properties. Given the reduced solubility of CH4, which facilitates outgassing and limits its transport in aquatic systems, the isotopic signatures are likely indicative of localized contributions from streambeds, adjacent water saturated soils, and lake outflows. Our study illustrates that dissolved greenhouse gases are sensitive indicators of old carbon release from thawing permafrost and serve as early warning signals for permafrost carbon feedbacks. It establishes a crucial baseline for understanding the role of CO2 and CH4 in regional carbon cycling and Arctic environmental change.
Impregnation problems of aluminum castings
Authors: Réger M , Horváth R , Fábian ER , Réti T
Published: October 2024

Vacuum impregnation is an effective solution to the porosity problem of aluminum die castings. Experience has shown that quality die-cast aluminum alloy products manufactured with gas tightness requirements can show leakage even after impregnation operation. The study seeks to answer the question of the geometry of the cavity system through which leakage occurs and why the cavity system is not saturated with liquid resin during impregnation. It is assumed that insufficient impregnation occurs if the near-surface parts of the cavity system are heavily deformed locally during the machining of the casting.
Redefining the strain aged state of unalloyed mild steels
Authors: Kondas B , Mertinger V
Published: October 2024

The unalloyed mild steels suitable for deep-drawing have a wide range of applications in the manufacturing industry. They are characterised by a high degree of cold formability, which is greatly reduced by the so-called “strain-aging” phenomenon. This leads to increased scrap formation, which is extremely detrimental to the metalworking industries. Strain-aging of steels is a complex subject with a very rich literature, although most of the research on unalloyed steels dates back to the 1970s and 1980s. Since then, steel making technology has developed intensively, which has also had an impact on the strain-aging process of unalloyed mild steels in practice. Our article describes the nature of the strain-aging phenomenon as it is experienced today. The degree of strain-aging described earlier in the literature is no longer fully present in mild steel products produced with today’s technology.
Manufacturing of composites with designed failure
Authors: Zs Marton G , Fendrik Á , Szebényi G
Published: October 2024

The failure of polymer composites is a very complex process, which mainly occurs as a result of interactions between different types of damage in the material, often at random locations and without any particular signs. To increase the reliability of composites and enable their wider use in safety-critical components, it is crucial to make their failure processes more controllable and predictable, which could be achieved by the local modification of the interfacial adhesion. The aim of our research is to develop and investigate a method for designing the failure process of polymer composites in terms of the location and the mode of failure. We produced interfacially engineered composites containing a weakened adhesion zone by adding polycaprolactone (PCL) thermoplastic interlayer material, which was applied directly on the surface of the reinforcing material by fused filament fabrication (FFF). Then, material tests were carried out, and the failure mode and position were evaluated as a function of the geometry of the interlayer material.
Corrigendum: Architectural membranes on building’s functional refurbishment (2017, IOP Conference Series: Materials Science and Engineering volume 264 (2017) 1-9/ 012005)
Authors: Macieira M , Mendonça P , Guedes J Miranda
Published: October 2024

Please see Article PDF for corrigendum text.
Rationalizing Inquiry and Historical Understanding
Authors: O’Brien Lilian
Published: October 2024

In ‘The Epistemic Goals of the Humanities’, Stephen Grimm (2024) argues for epistemic continuities between the humanities, on one hand, and the social and natural sciences, on the other. This paper focuses on discontinuities. Drawing inspiration from Svetlana Alexievich’s literary non-fiction, I argue that if a reader is to gain a specific kind of understanding of the actions of the agents who appear in such work, they must engage in a rational evaluation of those agents’ reasons and actions. This epistemic process may yield, not just understanding of another’s action, but a grip on the evaluative distance between the reader and the agents she reads about, together with a greater appreciation of normative matters. These epistemic gains are, I suggest, central to the value of the humanities, and play a key role in its corrective power.
Microbiome characterization of skin biopsies in Spanish patients with hidradenitis suppurativa shows a decrease in D1 and H1 lineages of Cutibacterium acnes
Authors: Romaní Jorge , Rosés Carles , Brillet François , Fernández-Vela Javier , Muñoz-Santos Carlos , Fábrega María José , Toloza Lorena , Pol Cros Maria , Güell Marc , Guilabert Antonio
Published: October 2024

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder, with dysbiosis and loss of Cutibacterium acnes commonly observed in affected skin. This study analysed the microbiome of lesional, perilesional and healthy skin samples, and found significant differences, including increased Mycoplasma and Bacillus in lesional skin. The reduction of Cutibacterium variants D1 and H1 in HS-affected skin highlights their potential as therapeutic targets, suggesting a strategy of topical replacement therapy.
Dopamine neuron dysfunction and loss in the PrknR275W mouse model of juvenile parkinsonism
Authors: Regoni Maria , Zanetti Letizia , Sevegnani Martina , Domenicale Chiara , Magnabosco Stefano , Patel Jyoti C , Fernandes Megan K , Feeley Ryan M , Monzani Elena , Mini Cecilia , Comai Stefano , Cherchi Laura , De Gregorio Danilo , Soliman Isabella , Ruto Fabio , Croci Laura , Consalez Giacomo , Rodighiero Simona , Ciammola Andrea , Valtorta Flavia , Morari Michele , Piccoli Giovanni , Rice Margaret E , Sassone Jenny
Published: October 2024

Mutations in the PRKN gene encoding the protein parkin cause autosomal recessive juvenile parkinsonism (ARJP). Harnessing this mutation to create an early-onset Parkinson’s disease mouse model would provide a unique opportunity to clarify the mechanisms involved in the neurodegenerative process and lay the groundwork for the development of neuroprotective strategies. To this end, we created a knock-in mouse carrying the homozygous PrknR275W mutation, which is the missense mutation with the highest allelic frequency in PRKN patients. We evaluated the anatomical and functional integrity of the nigrostriatal dopamine (DA) pathway, as well as motor behaviour in PrknR275W mice of both sexes.

We report here that PrknR275W mice show early DA neuron dysfunction, age-dependent loss of DA neurons in the substantia nigra, decreased DA content and stimulus-evoked DA release in the striatum, and progressive motor impairment. Together, these data show that the PrknR275W mouse recapitulates key features of ARJP. Thus, these studies fill a critical need in the field by introducing a promising new Parkinson’s disease model in which to study causative mechanisms of the disease and test therapeutic strategies.
Conflict of Laws Before International Arbitral Tribunals
Authors: Kupelyants Hayk
Published: October 2024

International disputes often require determining, as a preliminary matter, the content of rights and obligations at the municipal level. These rights and obligations are varied and include inter alia the rights in tangible and intangible property, domicile, status of foreign corporations, contractual and tortious obligations. However, the method of determining these matters is unclear. International tribunals rarely elaborate on the precise source of the conflict-of-laws rules they apply and their practice is at times inconsistent and incoherent. Nor are their constituent instruments necessarily determinative. The article examines the various sources of conflict-of-laws rules applicable before international arbitral tribunals, with lessons that could be useful for other international courts and tribunals. The article’s key contribution is to offer guidance, even if descriptive, for the determination of the governing law by international arbitral tribunals.
Evaluation of posterior mitral isthmus ablation in the absence of a vein of Marshall
Authors: François Clara , El Haddad Milad , De Becker Benjamin , De Smet Maarten , Le Polain de Waroux Jean-Benoît , Tavernier René , Duytschaever Mattias , Knecht Sébastien
Published: October 2024

Aims

Achieving acute and durable mitral isthmus (MI) block remains challenging using radiofrequency (RF) catheter ablation alone. Vein of Marshall (VoM) ethanolization results in chemical damage along the MI resulting in the creation of a durable transmural lesion with a very high rate of procedural block. However, no studies have systematically assessed the efficacy of MI ablation alone when no anatomical VoM is present.

Methods and results

Thirty seven patients without VoM evidenced after careful angiographic examination were included. Ablation parameters and result were compared with a matched control group in whom the posterior MI line was performed without assessing the presence of the VoM. Mitral isthmus block was achieved in 36 out of 37 patients without VoM (97%), with endocardial ablation only in 5/37 (14%) and combined endocardial and coronary sinus ablation in 32/37 patients (86%). There was a significant difference in the occurrence of block between patients without a VoM and the control group (97.3% vs. 65% respectively, P < 0.01), with a trend towards less needed RF {26 [interquartile range (IQR) 20–38] vs. 29 [IQR 19–40] tags [P = 0.8], 611 [IQR 443–805] vs. 746 [IQR 484–1193] seconds [P = 0.08]}.

Conclusion

The absence of a VoM is associated with a very high rate of procedural block during posterior MI ablation. The higher rate of MI block in this specific population would also suggest the crucial role of the VoM (when present) in resistant MI block.
Isolation, characterization, and genomic analysis of BUCT627: a lytic bacteriophage targeting Stenotrophomonas maltophilia
Authors: Hou Chenrui , Wang Xuexue , Guo Jianguang , Qi Chunling , Zhang Ying , Chen Yun , Feng Jiao , Zhao Bin , Li Fei
Published: October 2024

Stenotrophomonas infections pose significant therapeutic challenges due to escalating resistance to antibiotics and chemotherapeutic agents. Phages offer a potential solution by virtue of their specific bacterial targeting capabilities. In this study, we isolated a new Stenotrophomonas bacteriophage, named BUCT627, from hospital sewage. Phage BUCT627 exhibited a 30-min latent period and demonstrated a burst size of 46 plaque forming unit (PFU)/cell. Remarkably, this phage displayed robust stability across a wide pH range (pH 3–13) and exhibited resilience under varying thermal conditions. The receptor of phage BUCT627 on Stenotrophomonas maltophilia No. 826 predominantly consist of surface proteins. The complete genome of phage BUCT627 is a 61 860-bp linear double-stranded DNA molecule with a GC content of 56.3%, and contained 99 open reading frames and two tRNAs. Notably, no antibiotic resistance, toxin, virulence-related genes, or lysogen-formation gene clusters was identified in BUCT627. Transmission electron microscopy and phylogeny analysis indicated that this phage was a new member within the Siphoviridae family. The results of this study will enhance our understanding of phage diversity and hold promise for the development of alternative therapeutic strategies against S. maltophilia infections.
2-D sedimentary structures at the southeast margin of the Tarim Basin, China, constrained by Love wave ambient noise tomography
Authors: Xie Tongtong , Yang Yingjie , Xu Tao , Tian Xiaobo , Lin Jiyan , Wu Chenglong , Lu Zhanwu
Published: October 2024

Imaging the detailed structure of sedimentary basins is crucial for natural resource exploration and essential for better analysis and correction of sediment responses when studying deeper interior earth structures using seismic data. In the Tarim Basin, previous studies on the sedimentary structures are mostly obtained by active-source seismic surveys, which can provide high-resolution underground interface information but are highly costly or environmentally unfriendly. In this paper, ambient noise tomography, an efficient and economical method based on background vibration, is employed to construct the sedimentary velocity structure at the southeast margin of the Tarim Basin. Based on ambient noise data collected from a linear dense short-period seismic array, we extract Love wave signals from T–T component cross-correlation functions (CCFs) and measure Love wave dispersion curves at a period band of ∼0.3–11.5 s. Then, we utilize a one-step direct surface wave tomography method to image a fine 2-D sedimentary shear wave velocity structure with a depth reaching 10 km. Our results reveal a clear layered sedimentary structure, the palaeo Tadong uplift and the thrust Cherchen fault. Our study provides reference sedimentary velocity models for the southeastern Tarim Basin, focusing on depths shallower than 10 km. This model is intended to serve as crucial input for studies requiring detailed shallow sedimentary velocity data. Moreover, our research demonstrates that the application of the ambient noise tomography method with dense arrays has great potential for enhancing resource exploration efforts in sedimentary basins.
Service Access and Supportive Care Experiences among Urban and Rural Cancer Survivors: Informing Social Work Practice
Authors: Sweeney Leigh-Ann , Sharp Linda , McMullin Cheryl , Pearce Alison , Molcho Michal
Published: October 2024

Access to medical and supportive care services is important for the health and quality of life of cancer survivors; however, services are not always available or accessible to all survivors equally. This study aims to explore the experiences of cancer services among cancer survivors in urban and rural settings to inform social work practice. Authors conducted interviews with 25 cancer survivors (colorectal, n = 13; hematological, n = 12) in the West of Ireland, using a narrative inquiry approach. Thematic analysis was used to analyze the data. Authors found variations in the availability of supportive care services for urban and rural cancer survivors. Often, services designed to maximize survivors’ individualized choices and needs in community care were limited in rural communities, preventing some survivors from having their physical and psychological needs met. Additionally, access to services proved to be a barrier for rural cancer survivors. Rural survivors stated that traveling to appointments required time and planning, and the implications of travel costs were an increased burden. When rural survivors had good social support, access to services became less of an issue. The study confirms geographical disparities and recommends a review of supports that better meet survivors’ needs and informs social work practice.
Magnetic Curvature and Existence of a Closed Magnetic Geodesic on Low Energy Levels
Authors: Assenza Valerio
Published: October 2024

To a Riemannian manifold $(M,g)$ endowed with a magnetic form $\sigma $ and its Lorentz operator $\Omega $ we associate an operator $M^{\Omega }$, called the magnetic curvature operator. Such an operator encloses the classical Riemannian curvature of the metric $g$ together with terms of perturbation due to the magnetic interaction of $\sigma $. From $M^{\Omega }$ we derive the magnetic sectional curvature  $\textrm{Sec}^{\Omega }$ and the magnetic Ricci curvature  $\textrm{Ric}^{\Omega }$ that generalize in arbitrary dimension the already known notion of magnetic curvature previously considered by several authors on surfaces. On closed manifolds, under the assumption of $\textrm{Ric}^{\Omega }$ being positive on an energy level below the Mañé critical value, with a Bonnet–Myers argument, we establish the existence of a contractible periodic orbit. In particular, when $\sigma $ is nowhere vanishing, this implies the existence of a contractible periodic orbit on every energy level close to zero. Finally, on closed oriented even dimensional manifolds, we discuss about the topological restrictions that appear when one requires $\textrm{Sec}^{\Omega }$ to be positive.
Campanato Spaces via Quantum Markov Semigroups on Finite von Neumann Algebras
Authors: Hong Guixiang , Jing Yuanyuan
Published: October 2024

We study the Campanato spaces associated with quantum Markov semigroups on a finite von Neumann algebra $\mathcal M$. Let $\mathcal T=(T_{t})_{t\geq 0}$ be a Markov semigroup, $\mathcal P=(P_{t})_{t\geq 0}$ the subordinated Poisson semigroup and $\alpha>0$. The column Campanato space ${\mathcal{L}^{c}_{\alpha }(\mathcal{P})}$ associated to $\mathcal P$ is defined to be the subset of $\mathcal M$ with finite norm which is given by $$ \begin{align*} \|f\|_{\mathcal{L}^{c}_{\alpha}(\mathcal{P})}=\left\|f\right\|_{\infty}+\sup_{t>0}\frac{1}{t^{\alpha}}\left\|P_{t}|(I-P_{t})^{[\alpha]+1}f|^{2}\right\|^{\frac{1}{2}}_{\infty}. \end{align*} $$The row space ${\mathcal{L}^{r}_{\alpha }(\mathcal{P})}$ is defined in a canonical way. In this article, we will first show the surprising coincidence of these two spaces ${\mathcal{L}^{c}_{\alpha }(\mathcal{P})}$ and ${\mathcal{L}^{r}_{\alpha }(\mathcal{P})}$ for $0<\alpha <2$. This equivalence of column and row norms is generally unexpected in the noncommutative setting. The approach is to identify both of them as the Lipschitz space ${\Lambda _{\alpha }(\mathcal{P})}$. This coincidence passes to the little Campanato spaces $\ell ^{c}_{\alpha }(\mathcal{P})$ and $\ell ^{r}_{\alpha }(\mathcal{P})$ for $0<\alpha <\frac{1}{2}$ under the condition $\Gamma ^{2}\geq 0$. We also show that any element in ${\mathcal{L}^{c}_{\alpha }(\mathcal{P})}$ enjoys the higher-order cancellation property, that is, the index $[\alpha ]+1$ in the definition of the Campanato norm can be replaced by any integer greater than $\alpha $. It is a surprise that this property holds without further condition on the semigroup. Lastly, following Mei’s work on BMO, we also introduce the spaces ${\mathcal{L}^{c}_{\alpha }(\mathcal{T})}$ and explore their connection with ${\mathcal{L}^{c}_{\alpha }(\mathcal{P})}$. All the above-mentioned results seem new even in the (semi-)commutative case.
Show of force: Studying use of force across California’s high-security prisons
Authors: Glazer Amanda K , Rue Jeremy Sanchez
Published: October 2024

When a Californian high-security prison faced accusations of corruption and abuse, investigative reporters asked data researchers Amanda K. Glazer and Jeremy Sanchez Rue to pore over the data on use of force by correctional officers against inmates. What they discovered was troubling
Discovery of Perun (G329.9−0.5): a new, young, Galactic SNR
Authors: Smeaton Zachary J , Filipović Miroslav D , Lazarević Sanja , Alsaberi Rami Z E , Ahmad Adeel , Araya Miguel , Ball Brianna D , Bordiu Cristobal , Buemi Carla S , Bufano Filomena , Dai Shi , Haberl Frank , Hopkins Andrew M , Ingallinera Adriano , Jarrett Thomas , Koribalski Bärbel S , Kothes Roland , Kraan-Korteweg Renée C , Leahy Denis , Lundqvist Peter , Maitra Chandreyee , Martin Pierrick , Payne Jeffrey L , Rowell Gavin , Sano Hidetoshi , Sasaki Manami , Soria Roberto , Steyn Nadia , Umana Grazia , Urošević Dejan , Velović Velibor , Vernstrom Tessa , Vukotić Branislav , West Jennifer
Published: October 2024

We present the discovery of possibly the youngest Galactic supernova remnant (SNR) with associated pulsar-wind nebula (PWN), which we name Perun (G329.9−0.5). Perun was serendipitously discovered in the Australian Square Kilometre Array Pathfinder–Evolutionary Map of the Universe survey at 943 MHz, and subsequent follow-up observations were conducted with the Australia Telescope Compact Array observatory at 5500 and 9000 MHz. We combine these with additional radio observations from the MeerKAT, Molonglo Observatory Synthesis Telescope, and Murchison Widefield Array telescopes, infrared (IR) observations from the SpitzerSpace Telescope, and X-ray observations from the Chandra X-ray observatory to perform a multifrequency analysis. The radio morphology shows a small angular size shell (D = 70 arcsec) with a luminous, central PWN. We measure a total spectral index of $\alpha = -0.49\pm 0.05$, which should be typical for a young, composite SNR. Crucial evidence for Perun’s SNR classification comes from the detection of linear fractional polarization at radio frequencies of $\sim$7 per cent–10 per cent with both radial and tangential orientations, similar to the young SNR G1.9+0.3. We use data from the Southern Galactic Plane Survey to perform an H i analysis and estimate a favoured distance range of 6–9 kpc, and thus a favoured age range of $\sim$70–500 yr. We find no high-energy emission in Fermi-Large Area Telescope data. We detect Perun’s outer shell in 24 $\mu$m indicating the possible presence of [O iv] and [Fe iii] emission, also typical for young SNRs. Overall, these observations and analysis confirm Perun as a young, Galactic SNR with a prominent PWN.
Early steroid withdrawal and kidney transplant outcomes in first-transplant and retransplant recipients
Authors: Bae Sunjae , Chen Yusi , Sandal Shaifali , Lentine Krista L , Schnitzler Mark , Segev Dorry L , McAdams DeMarco Mara A
Published: October 2024

Background

Early steroid withdrawal (ESW) is often preferred over conventional steroid maintenance (CSM) therapy for kidney transplant recipients with low immunological risks because it may minimize immunosuppression-related adverse events while achieving similar transplant outcomes. However, the risk–benefit balance of ESW could be less favorable in retransplant recipients given their unique immunological risk profile. We hypothesized that the association of ESW with transplant outcomes would differ between first-transplant and retransplant recipients.

Methods

To assess whether the impact of ESW differs between first and retransplant recipients, we studied 210 086 adult deceased-donor kidney transplant recipients using the Scientific Registry of Transplant Recipients. Recipients who discontinued maintenance steroids before discharge from transplant admission were classified with ESW; all others were classified with CSM. We quantified the association of ESW (vs CSM) with acute rejection, death-censored graft failure and death, addressing retransplant as an effect modifier, using logistic/Cox regression with inverse probability weights to control for confounders.

Results

In our cohort, 26 248 (12%) were retransplant recipients. ESW was used in 30% of first-transplant and 20% of retransplant recipients. Among first-transplant recipients, ESW was associated with no significant difference in acute rejection {adjusted odds ratio (aOR) = 1.04 [95% confidence interval (CI) = 1.00–1.09]}, slightly higher hazard of graft failure [hazard ratio (HR) = 1.09 (95% CI = 1.05–1.12)] and slightly lower mortality [HR = 0.93 (95% CI = 0.91–0.95)] compared with CSM. Nonetheless, among retransplant recipients, ESW was associated with notably higher risk of acute rejection [OR = 1.42 (95% CI = 1.29–1.57); interaction P < .001] and graft failure [HR = 1.24 (95% CI = 1.14–1.34); interaction P = .003], and similar mortality [HR = 1.01 (95% CI = 0.94–1.08); interaction P = .04].

Conclusions

In retransplant recipients, the negative impacts of ESW on transplant outcomes appear to be non-negligible. A more conservatively tailored approach to ESW might be necessary for retransplant recipients.
Engineering of Phycourobilin Synthase: PubS to a Two-Electron Reductase
Authors: Miyake Keita , Iwata Saya , Narikawa Rei
Published: October 2024

Phycourobilin:ferredoxin oxidoreductase (PubS) belongs to the ferredoxin-dependent bilin reductase (FDBR) family and catalyzes the reduction of the C15=C16 double bond, followed by the C4=C5 double bond of biliverdin IXα to produce phycourobilin. Among the diverse FDBR enzymes that catalyze site-specific reduction reactions of bilins, PubS lineage is the only one that reduces the C4=C5 double bond. This family can be broadly divided into four-electron reduction enzymes, which catalyze two successive two-electron reductions, such as PubS, and two-electron reduction enzymes, which catalyze a single two-electron reduction. The crystal structures of diverse FDBRs, excluding PubS, have unraveled that there are two distinct binding modes in the substrate-binding pocket. In this study, we focused on the arginine (Arg) residues that is considered crucial for substrate-binding mode in two-electron reduction enzymes. Through sequence alignment and comparison with the predicted structure of PubS, we identified a residue in PubS that corresponds to the Arg residue in the two-electron reduction enzymes. We further introduced mutations to avoid the steric hindrance associated with changes in the binding mode. Biochemical characterization of these variants showed that we successfully modified PubS from a four-electron reduction enzyme to a two-electron reduction enzyme with the accumulation of radicals. Our results provide insight into the molecular mechanisms of the chromophore binding mode and proton donation from acidic residues.
Digital ulcers in systemic sclerosis are strongly associated with digital arterial disease: a finger-by-finger analysis of finger brachial pressure index measurements
Authors: Blaise Sophie , Boulon Carine , Mangin Marion , Senet Patricia , Lazareth Isabelle , Imbert Bernard , Lapebie François-Xavier , Lacroix Philippe , Seinturier Christophe , Constans Joël , Carpentier Patrick H
Published: October 2024

Objectives

The digital ulcers (DU) of SSc are disabling and frequent. Their pathogenesis involves a capillary microangiopathy and a digital arterial disease that few studies were able to quantify up to now. A multicentre observational study about the predictive value of capillaroscopy in SSc offered us the opportunity to evaluate further the complementary information provided by both capillary and arterial evaluations.

Methods

During the SCLEROCAP study, five out of the nine centres performed a systematic evaluation of the finger brachial pressure index (FBPI) in the last four fingers of both hands at baseline, using the same laser-Doppler device. In the present work, FBPI measurements were compared between fingers with vs without DU or scars, before and after adjusting for the capillaroscopic pattern and systemic factors.

Results

FBPI measurements were performed in 2537 fingers from 326 patients. Active ulcers or scars were found in 10.8% of those fingers, more often on the right hand, and in the second and third fingers. FBPI was lower than 0.70 in 26% of all fingers and in 57.5% of those with ulcers. A strong association was found between a low FBPI and the presence of DU, even after adjusting for capillaroscopic pattern, ulcer location and the patient himself.

Conclusion

These results confirm the importance of digital arterial disease in the pathogenesis of DU of SSc, which is independent from the microangiopathy. FBPI measurements complement the information provided by capillaroscopy and might have an important predictive value for subsequent DU.
The real-world use and effectiveness of avacopan in routine practice for the treatment of ANCA vasculitis. First experiences in Spain
Authors: Draibe Juliana , Espigol-Frigolé Georgina , Cid Maria Cinta , Prados M C , Guillén E , Villacorta J , Vega C , Martins J , daSilva I , Martin-Gomez Mª Adoración , Huerta A , Martinez-Valenzuela L , Morales Enrique
Published: October 2024

Objectives

ANCA-associated vasculitis (AAV) is a group of chronic diseases with relapses that associate organic damage because of the disease and its treatment. Avacopan is a new treatment indicated for AAV. We present the first experiences with avacopan in Spain as part of an Early Access program.

Methods

Patients with AAV who started avacopan between June 2022 and September 2023 were included. For comparison, a historical cohort of patients diagnosed with AAV around the same time and treated without avacopan was also included.

Results

Twenty-nine patients treated with avacopan were analysed. Twelve patients (41.4%) were male, and median age was 56 years. Most patients were ANCA MPO positive (21/29, 72.4%). The most frequently affected organ was the kidney (23/29, 79.31%), with a mean estimated glomerular filtration rate (eGFR) of 23.2 ml/min. Mean follow-up was 456.8 (±181.7) days with a remission rate of 86.2%. eGFR increased from 23.2 (11.2) to 38.38 (18.55) ml/min after 12 months of diagnosis. Two patients had adverse events related to avacopan (severe neutropenia and a gastrointestinal affectation), 13 infections were reported and one death. Patients treated with avacopan received a significantly lower cumulative dose of prednisone at 6 and 12 months (P-values of 0.02 and <0.01, respectively) compared with historical controls. The evolution of GFR at 1 year of follow-up and the incidence of relapse were similar in both groups.

Conclusion

The combination of avacopan with standard immunosuppressive therapy presents a good safety profile and provides added value by contributing to the control of AAV activity, increase GFR and removal of steroids.
Exosomal let‐7b‐5p deriving from parietal epithelial cells attenuate renal fibrosis through suppression of TGFβR1 and ARID3a in obstructive kidney disease
Authors: Song Ahui , Wang Minzhou , Xie Kewei , Lu Jiayue , Zhao Bingru , Wu Wangshu , Qian Cheng , Hong Wenkai , Gu Leyi
Published: October 2024

As renal progenitor cells, parietal epithelial cells (PECs) have demonstrated multilineage differentiation potential in response to kidney injury. However, the function of exosomes derived from PECs has not been extensively explored. Immunofluorescent staining of Claudin‐1 was used to identify primary PECs isolated from mouse glomeruli. Transmission electron microscopy, nanoparticle tracking analysis, and western blotting were used to characterize the properties of PECs‐derived exosomes (PEC‐Exo). The therapeutic role of PEC‐Exo in tubulointerstitial fibrosis was investigated in the unilateral ureteral obstruction (UUO) mouse model and TGF‐β1‐stimulated HK‐2 cells. High‐throughput miRNA sequencing was employed to profile PEC‐Exo miRNAs. One of the most enriched miRNAs in PEC‐Exo was knocked down by transfecting miRNA inhibitor, and then we investigated whether this candidate miRNA was involved in PEC‐Exo‐mediated tubular repair. The primary PECs expressed Claudin‐1, PEC‐Exo was homing to obstructed kidney, and TGF‐β1 induced HK‐2 cells. PEC‐Exo significantly alleviated renal inflammation and ameliorated tubular fibrosis both in vivo and in vitro. Mechanistically, let‐7b‐5p, highly enriched in PEC‐Exo, downregulated the protein levels of transforming growth factor beta receptor 1(TGFβR1) and AT‐Rich Interaction Domain 3A(ARID3a) in tubular epithelial cells (TECs), leading to the inhibition of p21 and p27 to restoring cell cycle. Furthermore, administration of let‐7b‐5p agomir mitigated renal fibrosis in vivo. Our findings demonstrated that PEC‐derived exosomes significantly repressed the expression of TGFβR1 and ARID3a by delivering let‐7b‐5p, thereby alleviating renal fibrosis. This study provides novel insights into the role of PEC‐Exo in the repair of kidney injury and new ideas for renal fibrosis intervention.
Do Obese Patients Have Worse Outcomes in Adult Spinal Deformity Surgeries?
Authors: Maroun Ralph , Daher Mohammad , Sleem Bshara , Nassar Joseph E. , Knebel Ashley , Callanan Tucker C. , Diebo Bassel G. , Sebaaly Amer , Daniels Alan H.
Published: October 2024

Study Design:

A meta-analysis study.

Objective:

This meta-analysis evaluates the difference in surgical outcomes between obese and nonobese patients undergoing adult spinal deformity (ASD) corrective surgery.

Background:

ASD encompasses a wide range of debilitating spinal abnormalities. Concurrently, obesity is on the rise globally and has been shown to influence the outcomes of ASD management. The relationship between obesity and surgical outcomes in ASD has been the focus of recent studies, yielding various results.

Materials and Methods:

We conducted a comprehensive search of PubMed, Cochrane, and Google Scholar (pages 1–20) through June of 2024. The surgical outcomes assessed included postoperative complications, revision rates, wound infections, thromboembolic events, implant-related complications, and nonhome discharge. Surgical parameters such as operative time, length of stay (LOS), and estimated blood loss (EBL), as well as functional outcomes like the Oswestry Disability Index (ODI) and pain scores were analyzed.

Results:

Nine studies met the inclusion criteria. Nonobese patients exhibited a lower rate of implant-related complications [odds ratio (OR)=0.25; 95% CI: 0.12–0.52, P=0.0002] and nonhome discharge (OR=0.52; 95% CI: 0.32–0.84, P=0.007). In addition, nonobese patients had reduced LOS (MD=−0.29; 95% CI: −0.53 to −0.05, P=0.02) and EBL (SMD=−0.68; 95% CI: −1.19 to −0.18, P=0.008). No statistically significant differences were observed for the remaining outcomes.

Conclusion:

Nonobese patients undergoing ASD corrective surgery are associated with fewer implant-related complications, a lower EBL, shorter LOS, and a higher likelihood of being discharged home compared with their obese counterparts.
Comparison of Patients with and without Predicted Surgical Indication between Clusters of Adult Spine Deformity (ASD) Patients
Authors: Baroncini Alice , Boissiere Louis , Larrieu Daniel , Haddad Sleiman , Pellisé Ferran , Alanay Ahmet , Kleinstueck Frank , Pizones Javier , Bourghli Anouar , Obeid Ibrahim ,   On behalf of the European Spine Study Group (ESSG)
Published: October 2024

Study design.

Multicentric, retrospective analysis of prospectively collected data.

Objective.

To utilize machine-learning (ML) for clustering and management prediction (conservative vs. operative) in surgically treated adult spine deformity (ASD) patients, and to compare the attainment of the Minimum Clinically Important Difference (MCID) between predicted surgical and conservative patients.

Summary of Background Data.

Management choice in ASD is complex. ML can identity patient clusters and predicted treatment, but it is unclear whether patients treated according to the prediction also show better clinical outcomes.

Methods.

ASD patients (2-year follow-up) were divided into groups using k-means clustering. Management choice was predicted among operated patients in each cluster. The MCID for the Oswestry Disability Index (ODI) and the Scoliosis Research Society-22 (SRS-22) was calculated and compared between patients with and without surgical prediction.

Results.

In Cluster 1 (idiopathic scoliosis, n=675, 150 surgeries), 57% of patients had a conservative prediction. Of these, 52% and 49% achieved MCID for ODI and SRS-22, respectively, compared to 68% and 75% for those with surgical predictions (OR=2 and 3.1, respectively).

In Cluster 2 (moderate sagittal imbalance, n=561, 200 surgeries), 12% had a conservative prediction. Of these, 29% and 46% achieved MCID for ODI and SRS-22, respectively, compared to 47% and 56% for those with surgical predictions.

In Cluster 3 (significant sagittal imbalance, n=537, 197 surgeries), 17% had a conservative prediction. Of these, 12% and 15% achieved MCID for ODI and SRS-22, respectively, compared to 37% and 45% for those with surgical predictions (OR=4.2 and 4.5, respectively).

Conclusion.

Patients with a concordant surgical prediction and management had higher odds of achieving the MCID, indicating a good correlation between prediction and clinical outcomes. In Cluster 3, the low percentage of patients with conservative prediction achieving the MCID suggests that machine learning could well identify patients with poor clinical outcomes.
Rescue of COVID-19 Patient Complicated by Spontaneous Pneumothorax and Acute Pulmonary Thromboembolism
Authors: Qu Jiachun , Dai Ruzhen
Published: October 2024

Pulmonary thromboembolism is a common cardiovascular disease, with high morbidity and mortality rates in hospitalized patients. Because of clotting disorders and hypoxemia caused by COVID-19, critically ill patients are highly susceptible to thrombotic complications. A study published in the Journal of the American Medical Association in 2022 showed that the incidence of venous thromboembolism (VTE) in critically ill COVID-19 patients was approximately 10% to 35%, whereas the incidence of VTE in autopsy cases was as high as 60% (JAMA Intern Med 182:1063-1070). Clinicians need increased awareness of VTE in COVID-19 patients, to reduce the risk of deep vein thrombosis and pulmonary thromboembolism and to be alert to life-threatening complications.
Surgical Intensive Care Unit Nurses’ Coping With Moral Distress and Moral Residue
Authors: Booth Adam T. , Christian Becky J.
Published: October 2024

Background

Moral distress is defined as knowing the right course of action to take but being hindered by institutional constraints.

Objective

The purpose of this study was to explore surgical intensive care unit (SICU) nurses’ experiences of moral distress, moral residue, coping, and perceived quality of patient care.

Method

A descriptive qualitative approach used in-depth, semistructured individual interviews of SICU nurses in a metropolitan, academic medical center until theoretical saturation occurred.

Results

Five themes were identified from 21 interviews. Root causes of moral distress were identified including end-of-life care, conflicts with management, staffing, inadequate resources, communication problems, power differentials between physicians and nurses, and working with incompetent providers. Interviews highlighted the torment experienced by participants, which demonstrated that unacknowledged moral distress impacted their quality of patient care and well-being. Accounts provided insight into patient care that was perceived to be wrong. Well-being was affected as 2 participants sought inpatient psychiatric treatment for moral distress, whereas others were looking for new nursing careers, and many were in school to leave the SICU.

Discussion

This study is unique because it corroborated Epstein and Hamric’s Crescendo Effect framework by providing in-depth analyses of moral distress, moral residue, and the crescendo effect and how these concepts developed within SICU nurses when left unaddressed. Interviews revealed that unacknowledged moral distress created moral residue, which subsequently impacted the quality of patient care and the nurses’ well-being.
Pediatric Resuscitation, Parental Presence, and Provider Perspective
Authors: Lindsay Julie , Hudgins Abbey , Patel Stephine
Published: October 2024

Background

Varying opinions and practices exist about parental presence during a pediatric resuscitation. In addition, there is a paucity of literature that investigates the perspectives of health care providers about the efficacy of parental presence in these situations.

Objectives

The aim of this study was to gain an understanding of the perspectives of emergency health care providers about parental presence during pediatric resuscitation.

Methods

This pilot study surveyed emergency health care providers about their opinions of parental presence during pediatric resuscitation. All participants were given a survey with closed- and open-ended questions. Data analysis included descriptive statistics for the demographic data and qualitative analysis for the open-ended responses.

Results

A total of 52 emergency services personnel completed the survey. Of the physician respondents, 78.2% (n = 18) were opposed to parental presence during pediatric resuscitation. Common reasons for opposition included the lack of education, interpersonal team communication skills or experience, and discussion concerning end-of-life issues.

Discussion

Utilization of formal education and simulation for parental presence during resuscitation could be helpful for increasing providers’ comfort levels with parental presence.
A New Test for Evaluating the Psychological Impact of COVID-19 in Nurses
Authors: Romero Carolina S. , Gimeno Paloma , Iftimi Adina , De Andrés José , Landoni Giovanni , Catalá Juan , Otero Maria ,   the PSIMCOV Group
Published: October 2024

Introduction

During the COVID-19 pandemic, many health care workers were involved and suffered significant physical and psychological strain, and nursing was one of the main players. Clearly and objectively establishing the psychological impact on nurses during the pandemic is necessary for long-term recovery and to be prepared for new outbreaks in the future.

Aim

The aims of this study were to evaluate the perceived impact on nurses at risk of psychological stress at work during a major health care crisis and determine the psychological impact and its influencing factors.

Methods

An online questionnaire was designed and distributed between April 9 and April 19, 2020, in Spain. The comprehensive self-conducted questionnaire included demographic information and the Psychological Stress and Adaptation at work Score. For the analysis, descriptive statistics, logistic regressions, and receiver operating characteristic curves were determined.

Results

A total of 825 nurses (33% working in intensive care units and emergency departments) answered the questionnaire. A logistic regression analysis revealed that nurses with higher psychological stress scores experienced more physical overload (P = .02), higher psychological overload (P < .01), poor teamwork (P = .02), more distress due to new circumstances (P < .01), more personal impact of how society responded to COVID-19 (P < .01), anticipation of negative future consequences (P < .01), and worse balance between family and work (P < .01). The area under the curve for the cutoff point of Psychological Stress and Adaptation at work Score 40 was 0.82 (95% confidence interval, 0.79-0.91), with 70% sensitivity and 81% specificity. The positive predictive value was 72%, and the negative predictive value was 80%.

Conclusion

Psychological Stress and Adaptation at work Score is a rapid and accurate test for evaluating the psychological well-being of health care staff that can be used when crisis prevents the use of conventional stress diagnosis methods. Higher psychological impact was observed in nurses who worked in the intensive care unit and in the hospital ward.