bluuebunny/crossref_metadata_2025 huggingface dataset:
Securing the right to assimilate: How the drafting of the genocide convention helped undermine language rights
Authors: Roche Gerald
Published: November 2024

This article focuses broadly on the problem of global language loss, and the underlying political dynamics that drive it. Noting that the United Nations currently promotes a rights-based approach to addressing this problem, I explore why language rights mechanisms are currently weak and fragmented. To do this, I focus on the tensions that exist between language rights and the sovereign rights claimed by states, based on a genealogical analysis of the drafting of the United Nations Convention on the Prevention and Punishment of the Crime of Genocide. Specifically, I examine why many drafters wanted to exclude protections for languages and linguistic minorities from the convention. My detailed narrative reconstruction shows that drafters removed consideration of languages from the convention in order to assert states’ rights to promote national languages, assimilate minorities, and prevent outside influence in domestic affairs. The article concludes by making suggestions for further research to deepen our understanding of the connections between sovereignty and language rights, while also arguing that effective solutions to the global crisis of language loss require the creation of a more robust language rights regime that acknowledges and confronts the implicit rights that states claim for themselves.
Decoupling narrative visualizations into components: Helping designers to tell data-driven stories
Authors: Borges Mariana Gomes , Corrêa Claiton Marques , Silveira Milene Selbach
Published: November 2024

There is a growing interest in presenting data clearly to users. One of the ways to increase engagement and understanding of this data is through narrative visualizations, as they utilize elements that can enhance understanding of the presented data in different ways. In this context, after a literature review on elements of narrative data visualizations, we identified a gap in detailed descriptions of narrative genres. Considering this, we conducted a focus group with professionals in the field, which resulted in the concept called “Navis Structure.” It organizes narrative genres into components for design assistance. In this case, the genres can be single-component or multi-component. Additionally, these genres were classified, considering not only this structure but also visual representation, interaction techniques, freedom of exploration, and narrative approach. Finally, we conducted a workshop with professionals experienced in data visualization to analyze and validate the proposed concept, believing that the findings contribute to advancing the understanding of narrative genres and guide future research in narrative data visualizations.
Syncopating the Ground Rhythm: W. E. B. Du Bois and Black Geographic Futurity on New Orleans’s North Claiborne Avenue
Authors: Brand Anna Livia
Published: November 2024

This research reads New Orleans’s North Claiborne’s 22-block landscape through a Du Boisian cartographic analytic that traces the ground rhythms of white supremacy and the syncopating daily life of Blacks residents’ resistance to racial oppression. Drawing on Du Bois’s The Philadelphia Negro as well as his work of speculative fiction, The Princess Steel, and cartographic experiments for the 1900 Paris World Exposition, and through textual and visual analyses of this critical Black geography, I argue that Du Boisian spatial analytics continue to be critical to how Black futures and freedom might be imagined. This Du Boisian analytic tends to archival and canonical absences; insists on the temporal, relational, and geographical dimensions of white supremacy; challenges the flattening of racial classificatory systems and cartographic logics; and represents heterogeneity as a rich and complex genealogical intermix of resistance across time and space. By reading North Claiborne for its geographical and temporal synergies, I draw on Du Bois to empirically grapple with and represent a capacious Black geographical imaginary and grounded praxis that blurs geographical and temporal delineations, contrasts white supremacy with freedom as a geographical praxis, and transposes abstract cartographies with Black life and placemaking.
Provincializing memory studies (again): Cosmopolitan, multidirectional, transcultural, and fugitive memories
Authors: Wegner Jarula MI
Published: November 2024

This essay argues for the need of provincializing memory studies concepts of the third phase. Memory studies and postcolonial studies share several characteristics, such as their historical emergence, interdisciplinary foundation, and interest in knowledge production. I suggest that postcolonial critique may further enrich memory studies through Dipesh Chakrabarty’s concept of provincializing Europe, because it may help memory studies to confront a tendency to universalize and naturalize some of its concepts, including cosmopolitan, multidirectional, and transcultural memory. A critical historical analysis of these concepts demonstrates that they are not so much universal, as they produce margins and exclusions. Analyzing Tracey Sankar-Charleau and Jude Charleau’s Trinidad and Tobago Carnival performance Lady Solanaceae Ligahoo, I argue that it is important to move beyond universals to also consider cultural memories’ historical specificity. Otherwise, memory studies may risk neglecting countless fugitive memories on the margins of societies, cultures, and histories.
Spatializing collective memory: The idea of home and the War and Women’s Human Rights Museum
Authors: Kim Jae Kyoung
Published: November 2024

Focusing on the idea of home, this article investigates collective memory embodied in the War and Women’s Human Rights Museum in Seoul, South Korea. Centering ‘comfort women’s’ trauma and resistance, it analyzes the museum’s memory narrative and spatial strategy, which guide visitors through an empathic journey from past to present, memory to action. I first define the museum’s site-specificity, examining how the idea of home emerged from its construction history. Thereafter, I analyze the museum’s spatial paradigm of collective memorialization through the lens of Gaston Bachelard’s interpretation of a house. Exploring visitors’ spatial awareness of ‘comfort woman’ victims, I argue that the museum, combining a metaphor of home with the victims’ memory, builds a strong emotional connection to the victims and thereby encourages visitors to act on their behalf.
Socioeconomic factors associated with poor patient-reported outcomes of 17,478 patients after a distal radial fracture
Authors: Jakobsson Hugo , Möller Michael , Cao Yang , Lundqvist Eva , Wretenberg Per , Sagerfors Marcus
Published: November 2024

This study aimed to investigate the association of socioeconomic factors, country of birth and comorbidities with poor patient-reported outcome 1 year after a distal radial fracture. The patient population was obtained from the Swedish Fracture Register. In the study, 17,468 patients 18 years or older were included. Poor outcome was the dependent variable in a multivariate logistic regression analysis. The factors with the strongest association with poor outcome were country of birth outside the European Union (odds ratio (OR) = 2.28; 95% CI = 1.91–2.73), high-energy trauma mechanism (OR = 1.76; 95% CI = 1.46–2.12), a history of anxiety or depression (OR = 1.46; 95% CI = 1.26–1.70), and a Charlson comorbidity index ≥3 (OR = 1.51; 95% CI = 1.17–1.94). Alleviating the effects of these factors could potentially decrease the proportion of patients with a disability after a distal radial fracture.

Level of evidence: III
Older Adults Benefit From Virtual Support for Continuous Glucose Monitor Use But Require Longer Visits
Authors: Weinstock Ruth S. , Raghinaru Dan , Gal Robin L. , Bergenstal Richard M. , Bradshaw Amy , Cushman Terra , Kollman Craig , Kruger Davida , Johnson Mary L. , McArthur Teresa , Olson Beth A. , Oser Sean M. , Oser Tamara K. , Beck Roy W. , Hood Korey , Aleppo Grazia
Published: November 2024

Background:

Older adults may be less comfortable with continuous glucose monitoring (CGM) technology or require additional education to support use. The Virtual Diabetes Specialty Clinic study provided the opportunity to understand glycemic outcomes and support needed for older versus younger adults living with diabetes and using CGM.

Methods:

Prospective, virtual study of adults with type 1 diabetes (T1D, N = 160) or type 2 diabetes (T2D, N = 74) using basal-bolus insulin injections or insulin pump therapy. Remote CGM diabetes education (3 scheduled visits over 1 month) was provided by Certified Diabetes Care and Education Specialists with additional visits as needed. CGM-measured glycemic metrics, HbA1c and visit duration were evaluated by age (<40, 40-64 and ≥65 years).

Results:

Median CGM use was ≥95% in all age groups. From baseline to 6 months, time 70 to 180 mg/dL improved from 45% ± 22 to 57% ± 16%; 50 ± 25 to 65 ± 18%; and 60 ± 28 to 69% ± 18% in the <40, 40-64, and ≥65-year groups, respectively (<40 vs 40-64 years P = 0.006). Corresponding values for HbA1c were 8.0% ± 1.6 to 7.3% ± 1.0%; 7.9 ± 1.6 to 7.0 ± 1.0%; and 7.4 ± 1.4 to 7.1% ± 0.9% (all P > 0.05). Visit duration was 41 min longer for ages ≥65 versus <40 years ( P = 0.001).

Conclusions:

Adults with diabetes experience glycemic benefit after remote CGM use training, but training time for those >65 years is longer compared with younger adults. Addressing individual training-related needs, including needs that may vary by age, should be considered.
Understanding the burden of weekly somatrogon injections compared with daily somatropin injections in children with growth hormone deficiency: a plain language summary of publication
Authors: Maniatis Aristides K. , Carakushansky Mauri , Galcheva Sonya , Prakasam Gnanagurudasan , Fox Larry A. , Dankovcikova Adriana , Loftus Jane , Palladino Andrew A. , Resa Maria de los Angeles , Taylor Carrie Turich , Dattani Mehul T. , Lebl Jan
Published: November 2024

• For children with growth hormone deficiency, once-weekly somatrogon injections were less of a burden than once-daily somatropin injections.

• The safety of weekly somatrogon was similar to that of daily somatropin.

• Compared with daily somatropin injections, children with growth hormone deficiency may be less likely to miss weekly somatrogon injections.

 ○ This is because weekly somatrogon injections were less of a burden and were less likely to interfere with daily activities compared with daily somatropin injections.

The purpose of this plain language summary is to help you to understand the findings from recent research.

• Somatrogon is used to treat the condition under study that is discussed in this summary. Approval varies by country; please check with your local provider for more details.

• The results of this study may differ from those of other studies. Health professionals should make treatment decisions based on all available evidence and not on the results of a single study.

This original scientific article on which this summary is based was published in the Journal of the Endocrine Society and can be accessed for free at: https://academic.oup.com/jes/article/6/10/bvac117/6695276 . The details of the original article are as follows: Aristides K. Maniatis, Mauri Carakushansky, Sonya Galcheva, Gnanagurudasan Prakasam, Larry A. Fox, Adriana Dankovcikova, Jane Loftus, Andrew A. Palladino, Maria de los Angeles Resa, Carrie Turich Taylor, Mehul T. Dattani, Jan Lebl. Treatment burden of weekly somatrogon versus daily somatropin in children with growth hormone deficiency: a randomized study. J Endocr Soc 2022; 6(10): bvac117. DOI: 10.1210/jendso/bvac117.
Lumbar Spinal Stenosis Grading in Multiple Level Magnetic Resonance Imaging Using Deep Convolutional Neural Networks
Authors: Won Dongkyu , Lee Hyun-Joo , Lee Suk-Joong , Park Sang Hyun
Published: November 2024

Study Design

Retrospective magnetic resonance imaging grading with comparison between experts and deep convolutional neural networks (CNNs).

Objective

The application of deep learning to clinical diagnosis has gained popularity. This approach can accelerate image interpretation and serve as a screening tool to help doctors.

Methods

A comparison was conducted between retrospective magnetic resonance imaging (MRI) grading performed by experts and grading obtained using CNN classifiers. Data were collected from the lumbar axial dataset in the DICOM format. Two experts labeled the sampled images using the same diagnostic tools: localization of patches near the spinal canal, rootlet leveling, and stenosis grading. Comprehensive comparisons were presented for both rootlet cord classification and stenosis grading.

Results

Rootlet-cord classification for the two analyzers was 90.3% and the F1 score was 86.6%. The agreement of Analyzers-Classifiers was 92.7% and 96.8% for data with 90.6% and 95.6% F1 scores, respectively. For stenosis grading, there was an agreement of 89.2% between the two analyzers, resulting in an F1 score of 76.5%. The grades of the Analyzers-Classifiers agreed on 91.5/89.4% of the data, with an F1 score of 78.4/75.7%. Analyzer1 and Analyzer2 classified >74% as grade A (78.8% and 74.4%, respectively), 15.4% and 18.6% as grade B, 4.2% and 6.0% as grade C, and 1.6% and 2.0% as grade D, respectively.

Conclusions

The fully automated deep learning model showed competitive results in stenosis grade diagnosis and rootlet cord classification under similar anatomical conditions. However, abrupt anatomical changes can lead to a puzzle diagnosis based only on images.
Monetary and Fiscal Policy Impacts on the Indian Sovereign Bond Market: A VAR Approach
Authors: Kumar Anshul , Sarkar Agnirup , Sengupta Bodhisattva
Published: November 2024

This study analyses the dynamic relationship between yield curve behaviour and the macroeconomy in India, with a focus on both monetary and fiscal policy impacts. Using the monthly data on yields of Treasury bills and government securities from April 2000 to March 2020, we employ principal component analysis to extract the three yield curve factors—level, slope and curvature. We then use an unrestricted vector autoregressive model to analyse the relationship between these three yield curve factors and macroeconomic variables: inflation, GDP growth, exchange rate and monetary and fiscal policy indicators. Our findings reveal a bidirectional causality between yield curve factors and macroeconomic variables. Monetary policy plays an important role in shaping the yield curve, with short-term rates having more pronounced effects than long-term rates. Notably, this study is among the first to incorporate fiscal policy indicator in the Indian context, providing a more comprehensive understanding of policy impacts on the sovereign bond market. Our results offer valuable insights for policymakers and investors, showing the interrelationship of fiscal and monetary policies with bond market dynamics in emerging economies. This research contributes to the growing macrofinance literature and enhances our understanding of financial market dynamics in a developing economy.

JEL Classification: E430, C32, G120, E44
Picture Perfect: A Task Interdependence and Communication Experiential Activity for Teams
Authors: Ashouri Noor , Cuconato Gabriela , Ehasz Sharon F. , Moreno Francisco J. , Perkins Benjamin G. , Alley Leah , De La Haye DC , Feddeck Maria V. , Gupta Alisha , Hite-Womack Simona , May Kaleigh , Smith Shona G.
Published: November 2024

Effective communication in interdependent group tasks plays a pivotal role in organizational effectiveness, especially in today’s dynamic and global workplace. As the modern workplace evolves toward more remote work environments and dynamic work teams, the ability to adapt communication strategies across various job designs and work settings becomes increasingly crucial. In this article, we present an experiential learning activity designed for management education that delves into the impact of task design on communication. Drawing from theories of team interdependence, this immersive experience enables students to identify the essential facets of communication and their relationship with various types of task interdependence. It equips them with valuable skills and communication strategies that are vital for various types of teamwork across different types of settings. Suitable for a wide range of educational settings, this experiential activity serves as a valuable resource for management educators.
Evolving national guidelines for the treatment of children and adolescents with gender dysphoria: International perspectives
Authors: Kozlowska Kasia , Ambler Geoffrey R , Dechêne Sophie , Almaraz Almaraz Maria Cruz , Eliacheff Caroline , Entwistle Kirsty , Esteva de Antonio Isabel , Gómez Gil Esther , Hofman Paul , Hunter Patrick , Kaltiala Riittakerttu , Koener Beryl , Landén Mikael , Ledrait Alexandre , Maguire Ann M , Masson Céline , O’Malley Stella , Raven Melissa , Ryan Hannah , Wæhre Anne , Williamson Catherine , Zucker Kenneth J , Scher Stephen
Published: November 2024

From the early years of this century, many Western countries adopted the “Dutch Protocol” as a new medical pathway for treating children and adolescents with childhood-onset gender dysphoria. On this approach, gonadotrophin-releasing hormone agonists (GnRHa) were used to suppress puberty, followed by cross-sex hormones (testosterone or oestrogen). This perspective article traces—in each of the countries where we, the authors, live and work—how the Dutch Protocol came to be incorporated into clinical practice or formally adopted into national guidelines. Over time, guidelines across different countries were progressively shaped by a rights-based approach that removed previous safeguards and increased availability of gender-reassignment medical interventions for children and adolescents. From 2010 onward, two developments raised new concerns, generating alternate perspectives and wide-ranging differences in clinical approach. Numerous countries reported an unexpected increase in adolescent-onset presentations, especially among girls. During the same period, an increasing number of individuals who had undergone gender-reassignment medical interventions as minors reported harm and regret. Worldwide, questions were raised about the safety of clinical guidelines for children and adolescents presenting with gender dysphoria. Government bodies in Finland, Sweden, the United Kingdom, and the U.S. state of Florida commissioned systematic reviews pertaining to hormone treatments and issued formal reports. In a parallel process, “conversion therapy” laws, passed in many countries, closed access to exploratory psychotherapy that enables exploration of gender-identity issues from a neutral therapeutic stance. Taken together, these three developments introduced evidence-based and legal considerations into the debate, resulting in tensions that remain unresolved.
Resisting dystopian visions of urban policy: A dialogical analysis of speeches from Danish anti-ghetto-law protests
Authors: Madsen Thomas , Morton Thomas , Power Séamus A.
Published: November 2024

The current research studies demonstrations held in Copenhagen, Denmark, between 2020 and 2023 in the wake of the 2018 ‘parallel society agreement’ (a.k.a. ‘ghetto-laws’). The stated aim of this legislation was to facilitate the integration of ethnic minorities into mainstream society by drawing middle-class Danish residents into public housing areas defined by high levels of ethnic minority populations. We draw on dialogical and socio-cultural psychology to view demonstrations as communicative settings in which speakers locate problems, imagine futures and suggest pathways for action. Speakers’ problematizations and engagements with scenarios of collective action were formulated around three thematic domains: (1) intentions and motives of ‘institutional others’; (2) dystopia-utopia and; (3) expanding a constrictive future. As the legislation was increasingly implemented throughout the 3-year period, this was reflected in dialogical dynamics between different temporalities; and as a lawsuit initiated by a group of residents seemed to gain ground, this sustained a horizon of hope and volition. On a more general level, we stress the significance of the legal domain for engaging with the possible – particularly for urban social movements fighting for the ‘right to the city’. We similarly discuss the implications of our results for addressing urban marginalization.
Effects of systemic ventricular assist in failing Fontan patients: a theoretical analysis using a computational model
Authors: Kisamori Eiri , Kotani Yasuhiro , Shishido Toshiaki , Kasahara Shingo , Shimizu Shuji
Published: November 2024

Mechanical circulatory support is a potential treatment for failing Fontan patients. In this study, we performed a theoretical analysis using a computational model to clarify the effects of systemic ventricular assist device (VAD) in failing Fontan patients. Cardiac chambers and vascular systems were described using the time-varying elastance model and modified Windkessel model, respectively. A VAD was simulated as a nonlinear function. In systolic and diastolic ventricular dysfunction and atrioventricular valve regurgitation models, systemic VAD increased the cardiac index and decreased the central venous pressure (CVP). However, in the high pulmonary vascular resistance model, CVP became extremely high above 15 mmHg to maintain the cardiac index when the pulmonary vascular resistance index (PVRI) was above 5 Wood units m2. In Fontan patients with ventricular dysfunction or atrioventricular valve regurgitation, systemic VAD efficiently improves the hemodynamics. In Fontan patients with PVRI of > 5 Wood units m2, systemic VAD seems ineffective.
Primary cutaneous infections with non-tuberculous mycobacteria: a report of 6 cases
Authors: Yao Qi-Hao , Zhi Hui-Lin , Xia Xiu-Jiao , Liu Ze-Hu
Published: November 2024

Background

The incidence of non-tuberculous mycobacterium infection has shown a gradual increasing trend in recent years, among which cutaneous manifestations as an important aspect. This study aimed to describe the clinical features and microbiological findings in 6 cases of primary cutaneous nontuberculous mycobacterium infection.

Methods

In this retrospective study from June 2021 to June 2022, the clinical data and microbiological results of six cases diagnosed with primary cutaneous non-tuberculous mycobacterium infection in department of dermatology, Hangzhou Third People’s Hospital were analyzed.

Results

All six cases were primary cutaneous non-tuberculous mycobacterium infections, four of which had a history of trauma or exposure, and two had an underlying disease that could lead to compromised immunity. All patients presented with erythema nodular skin lesions, four on the upper or lower extremities, one on the face, and one on the right hip. The histopathological findings of five patients who underwent biopsy were granulomatous inflammatory changes with mixed infiltration. Laboratory cultures using tissue or tissue fluid were all successful, including fourMycobacterium marinum, oneMycobacterium abscessus, and oneMycobacterium avium. Metagenomics next-generation sequencing detected results consistent with culture colonies in only two cases. With the exception of case 4, all patients responded well to oral medication, with a course of treatment ranging from 4 months to 1 year, and the prognosis was good.

Conclusions

The clinical features of primary cutaneous non-tuberculous mycobacterium infection are often lacking in specificity, and the identification of related strains is difficult for a variety of reasons. Although the results of metagenomics next-generation sequencing are useful for pathogen spectrum identification, its diagnostic value should be carefully reevaluated under certain circumstances. Patients with suspected triggers who do not respond well to conventional treatments should be suspected as atypical infection and potential immunosuppression. If diagnosed and treated promptly, the prognosis of primary cutaneous non-tuberculous mycobacterium infection is generally good.
Effectiveness of pulse methylprednisolone in patients with non-human immunodeficiency virus pneumocystis pneumonia: a multicentre, retrospective registry-based cohort study
Authors: Morimoto Yasuhiro , Matsui Hiroki , Fujioka Haruka , Homma Yuya , Nagai Tatsuya , Otsuki Ayumu , Ito Hiroyuki , Ohmura Shin-ichiro , Miyamoto Toshiaki , Shichi Daisuke , Watari Tomohisa , Otsuka Yoshihito , Nakashima Kei
Published: November 2024

Background

A recent database study and meta-analysis reported that adjunctive glucocorticoid therapy reduces mortality in patients with non-human immunodeficiency virus-associated (non-HIV) Pneumocystis jirovecii pneumonia (PCP), having hypoxemia. However, the optimal glucocorticoid dose remains unclear. Our study aimed to evaluate the effectiveness of pulse methylprednisolone compared with mild-to-moderate steroid doses in patients with non-HIV PCP.

Methods

This multicentre retrospective cohort study included adults with non-HIV PCP receiving adjunctive steroids at three Japanese tertiary care hospitals from June 2006 to March 2021. Patients were categorised into pulse methylprednisolone and mild-to-moderate dose groups. Pulse methylprednisolone involved an initial intravenous infusion of 500–1000 mg methylprednisolone daily, while the mild-to-moderate dose was lower. Primary and secondary outcomes were 30-day and 180-day mortality from treatment initiation. Patient characteristics were adjusted using propensity score analysis with overlap weighting. Subgroup analysis focused on patients with respiratory failure.

Results

The study included 139 patients with non-HIV PCP: 55 in the pulse methylprednisolone group and 84 in the mild-to-moderate dose group. After adjusting for patient background, 30-day mortality (14.2% vs. 15.5%, P = 0.850) and 180-day mortality (33.5% vs. 27.3%, P = 0.516) did not differ significantly between groups. Subgroup analysis revealed no significant associations among patients with respiratory failure.

Conclusions

After adjusting for patient characteristics, no difference in prognosis was observed between pulse methylprednisolone and mild-to-moderate dose groups in patients with non-HIV PCP. A mild-to-moderate dose of adjunctive corticosteroid may suffice for treating non-HIV PCP.
Designing and deploying caller tunes on mobile phones to promote malaria vaccine uptake in Africa: can the technology acceptance model (TAM) help?
Authors: Eneh Stanley , Onukansi Francisca , Ikhuoria Ogechi , Ojo Temitope
Published: November 2024

Malaria remains a significant global health challenge, with millions of cases and high mortality rates annually, especially in low-income countries. Africa bears a substantial burden, with direct costs of malaria among children under five reaching millions of dollars in countries like Ghana, Tanzania, and Kenya. In 2021, over 610,000 malaria-related deaths were reported, 96% of which occurred in sub-Saharan Africa. Despite existing interventions, such as long-lasting insecticidal nets, indoor residual spraying, and intermittent preventive treatment, the re-emergence of malaria underscores the need for innovative preventive strategies. This study explores the potential of utilizing mobile phone caller tunes to raise awareness and promote the uptake of the RTS,S malaria vaccine. The technology acceptance model (TAM) provides a framework for understanding how users perceive and adopt new technologies. Caller tunes, a mobile phone feature that plays audio for callers waiting to be connected, have been effective in health communication campaigns in Asia and Africa. This approach could be leveraged to enhance malaria vaccine awareness, particularly in low-income countries where vaccine hesitancy is prevalent and malaria endemic. Overall, mobile technologies have significantly improved healthcare delivery in Africa, facilitating communication, monitoring, and treatment adherence in remote areas. Integrating caller tunes with health messages about the malaria vaccine could address vaccine hesitancy and improve uptake. This would require collaboration with telecommunication companies, healthcare providers, and policymakers to design culturally and linguistically appropriate messages. However, the cost of caller tune services, the need for internet access, and cultural differences are the expected challenge that may occur in this approach. Therefore, strategic partnerships and intersectoral approaches can mitigate these issues, making caller tunes a viable tool for public health communication. Raising awareness through this innovative method could enhance the adoption of the RTS,S vaccine and support ongoing malaria control efforts in Africa.
Discrimination experiences of transgender individuals in healthcare: an interview study on the perspective of health professionals specializing in the treatment of transgender individuals
Authors: Skuban-Eiseler Tobias , Orzechowski Marcin , Steger Florian
Published: November 2024

Background

Experiences of discrimination in healthcare lead to poorer mental and physical health for transgender individuals. There is evidence that trans-specialists, i.e. health professionals specializing in transgender care, are an important source of discrimination experienced by transgender individuals in healthcare. In this qualitative interview study, we explored the reasons for this possibly surprising finding by analyzing subjective views of trans-specialists on various issues related to discrimination of transgender individuals.

Methods

We conducted 20 semi-structured, qualitative, exploratory interviews with healthcare professionals specializing in transgender care. Interview questions were developed based on an extensive literature analysis and results of previous research on the topic. The interviews were conducted online, were digitally recorded and transcribed. Data analysis was conducted using the methods of content analysis and thematic analysis.

Results

The interviewees had great difficulty giving a consistent definition of the concept of gender identity. Most of them saw it as a self-determination of a transgender individual. Although herewith emphasizing the autonomy of transgender individuals, most trans-specialists felt that they had to be convinced of their patient’s transsexuality to carry out treatment. Most trans-specialists reported having had doubts about whether some transgender individuals were suffering from gender incongruence or not. There was also ambiguity among interviewees about whether transsexuality is a mental illness.

Conclusions

We were able to identify specific topics that can cause discrimination experiences on the part of transgender individuals in their contact with trans-specialists. These include the vagueness of the construct of gender identity and the ambivalence between respect for the autonomy of transgender individuals and the validation of the diagnosis “transsexuality”. Also, uncertainties regarding the classification of transsexuality as a mental illness can lead to experiences of discrimination. Furthermore, our results imply that trans-specialists might remember own discriminatory behavior less than it actually took place. Our results can contribute to the development of specific measures to avoid discrimination experiences of transgender individuals in contact with trans-specialists. These should include a reflection on one’s own gender identity and training on mechanisms of discrimination.
Wealth-related disparities of comprehensive knowledge of HIV among reproductive-aged women in Ethiopia: a decomposition analysis
Authors: Alemu Samrawit Birhanu , Abate Aynalem Belay , Yizengaw Mekedes Tamiru , Anebo Sisay Hanfesa , Alemu Melaku Birhanu
Published: November 2024

Introduction

Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) remains a major global public health concern, especially in low-income countries like Ethiopia. Insufficient awareness about HIV/AIDS makes women vulnerable to infection. Notably, there is a disparity in the comprehensive HIV knowledge among reproductive-aged women in poorer and wealthier households. However, the contributing factors for wealth-related disparities in comprehensive knowledge of HIV among reproductive-aged women in Ethiopia have not been explored.

Methods

We used the women's record (IR) of the 2016 Ethiopian demographic health survey. Erreygers normalized concentration index and curve were used to analyze the percentage contribution of factors in the comprehensive knowledge of HIV difference across wealth index. The concentration index was decomposed into contributing factors for poor comprehensive knowledge among poorer households.

Results

A total of 14,599 reproductive-aged women were included in the analysis. The comprehensive knowledge of HIV was 14.75% and 29.33% in the poorest and wealthiest households, respectively. The weighted Erreygers normalized concentration index (ECI) was 0.11 with Standard error = 0.015 (P value < 0.05). Age (− 0.17%), residence (1.4%), education (26.2%), occupation (1.38%), region (0.61%), wealth index (30.8%), media exposure (13.4%), and internet access (0.67%) significantly contributed to the wealth-related inequalities.

Conclusion

There was a pro-rich distribution of comprehensive knowledge of HIV among reproductive-age women in Ethiopia. Wealth, education, and media exposure were the major contributing factors to the wealth-related inequalities. Policymakers should prioritize media exposure and education, and work to improve the comprehensive knowledge of women in poorer households.
Shared decision making in primary malignant bone tumour surgery around the knee in children and young adults: protocol for a prospective study
Authors: Blom Kiki J , Bekkering Willem P , Fiocco Marta , van de Sande Michiel AJ , Schreuder Hendrik WB , van der Heijden Lizz , Jutte Paul C , Haveman Lianne M , Merks Johannes HM , Bramer Jos AM
Published: November 2024

Background

Children and young adults needing surgery for a primary malignant bone tumour around the knee face a difficult, life-changing decision. A previous study showed that this population wants to be involved more in the decision-making process and that more involvement leads to less decisional stress and regret. Therefore, a well-designed and standardized decision-making process based on the principles of shared decision-making needs to be designed, implemented, and evaluated.

Methods

We developed a shared decision-making (SDM) model for this patient population, including an online decision aid (DA). This model has been implemented in the standard care of patients with a primary malignant bone tumour around the knee. Following implementation, we will analyse its effect on the decision-making process and the impact on patient experiences using questionnaires and interviews. Moreover, potential areas for improvement will be identified.

Discussion

Given the importance of involving patients and parents in surgical decision-making, particularly in life-changing surgery such as malignant bone tumour surgery, and given the lack of SDM models applicable for this purpose, we want to share our model with the international community, including our study protocol for evaluating and optimising the model. This study will generate valuable knowledge to facilitate the optimisation of current patient care for local treatment. The sharing of our implementation and study protocol can serve as an example for other centres interested in implementing SDM methods in an era characterized by more empowered patients and parents who desire autonomy and reliable and realistic information.
Simultaneous saccharification and fermentation for d-lactic acid production using a metabolically engineered Escherichia coli adapted to high temperature
Authors: Pérez-Morales Gilberto , Caspeta Luis , Merino Enrique , Cevallos Miguel A. , Gosset Guillermo , Martinez Alfredo
Published: November 2024

Background

Escherichia coli JU15 is a metabolically engineered strain capable to metabolize C5 and C6 sugars with a high yield of d-lactic acid production at its optimal growth temperature (37 °C). The simultaneous saccharification and fermentation process allow to use lignocellulosic biomass as a cost-effective and high-yield strategy. However, this process requires microorganisms capable of growth at a temperature close to 50 °C, at which the activity of cellulolytic enzymes works efficiently.

Results

The thermotolerant strain GT48 was generated by adaptive laboratory evolution in batch and chemostat cultures under temperature increments until 48 °C. The strain GT48 was able to grow and ferment glucose to d-lactate at 47 °C. It was found that a pH of 6.3 conciliated with GT48 growth and cellulase activity of a commercial cocktail. Hence, this pH was used for the SSF of a diluted acid-pretreated corn stover (DAPCS) at a solid load of 15% (w/w), 15 FPU/g-DAPCS, and 47 °C. Under such conditions, the strain GT48 exhibited remarkable performance, producing d-lactate at a level of 1.41, 1.42, and 1.48-fold higher in titer, productivity, and yield, respectively, compared to parental strain at 45 °C.

Conclusions

In general, our results show for the first time that a thermal-adapted strain of E. coli is capable of being used in the simultaneous saccharification and fermentation process without pre-saccharification stage at high temperatures.
Auditory N1 event-related potential amplitude is predictive of serum concentration of BPN14770 in fragile X syndrome
Authors: Norris Jordan E. , Berry-Kravis Elizabeth M. , Harnett Mark D. , Reines Scott A. , Reese Melody A. , Outterson Abigail H. , Michalak Claire , Furman Jeremiah , Gurney Mark E. , Ethridge Lauren E.
Published: November 2024

Fragile X syndrome (FXS) is a rare neurodevelopmental disorder caused by a CGG repeat expansion ≥ 200 repeats in 5’ untranslated region of the FMR1 gene, leading to intellectual disability and cognitive difficulties, including in the domain of communication. A recent phase 2a clinical trial testing BPN14770, a phosphodiesterase 4D inhibitor, showed improved cognition in 30 adult males with FXS on drug relative to placebo. The initial study found significant improvements in clinical measures assessing cognition, language, and daily functioning in addition to marginal improvements in electroencephalography (EEG) results for the amplitude of the N1 event-related potential (ERP) component. These EEG results suggest BPN14770 improved neural hyperexcitability in FXS. The current study investigated the relationship between BPN14770 pharmacokinetics and the amplitude of the N1 ERP component from the initial data. Consistent with the original group-level finding post-period 1 of the study, participants who received BPN14770 in period 1 showed a significant correlation between N1 amplitude and serum concentration of BPN14770 measured at the end of period 1. These findings strengthen the validity of the original result, indicating that BPN14770 improves cognitive performance by modulating neural hyperexcitability. This study represents the first report of a significant correlation between a reliably abnormal EEG marker and serum concentration of a novel pharmaceutical in FXS.
Advances in drug-induced liver injury research: in vitro models, mechanisms, omics and gene modulation techniques
Authors: Guo Kaidi , van den Beucken Twan
Published: November 2024

Drug-induced liver injury (DILI) refers to drug-mediated damage to the structure and function of the liver, ranging from mild elevation of liver enzymes to severe hepatic insufficiency, and in some cases, progressing to liver failure. The mechanisms and clinical symptoms of DILI are diverse due to the varying combination of drugs, making clinical treatment and prevention complex. DILI has significant public health implications and is the primary reason for post-marketing drug withdrawals. The search for reliable preclinical models and validated biomarkers to predict and investigate DILI can contribute to a more comprehensive understanding of adverse effects and drug safety. In this review, we examine the progress of research on DILI, enumerate in vitro models with potential benefits, and highlight cellular molecular perturbations that may serve as biomarkers. Additionally, we discuss omics approaches frequently used to gather comprehensive datasets on molecular events in response to drug exposure. Finally, three commonly used gene modulation techniques are described, highlighting their application in identifying causal relationships in DILI. Altogether, this review provides a thorough overview of ongoing work and approaches in the field of DILI.
Elevated levels of butyric acid in the jejunum of an animal model of broiler chickens: from early onset of Clostridium perfringens infection to clinical disease of necrotic enteritis
Authors: Gautam Hemlata , Shaik Noor Ahmad , Banaganapalli Babajan , Popowich Shelly , Subhasinghe Iresha , Ayalew Lisanework E. , Mandal Rupasri , Wishart David S. , Tikoo Suresh , Gomis Susantha
Published: November 2024

Background

Necrotic enteritis (NE) is an economically important disease of broiler chickens caused by Clostridium perfringens (CP). The pathogenesis, or disease process, of NE is still not clear. This study aimed to identify the alterations of metabolites and metabolic pathways associated with subclinical or clinical NE in CP infected birds and to investigate the possible variations in the metabolic profile of birds infected with different isolates of CP.

Methodology

Using a well-established NE model, the protein content of feed was changed abruptly before exposing birds to CP isolates with different toxin genes combinations (cpa, cpb2, netB, tpeL; cpa, cpb2, netB; or cpa, cpb2). Metabolomics analysis of jejunal contents was performed by a targeted, fully quantitative LC-MS/MS based assay.

Results

This study detected statistically significant differential expression of 34 metabolites including organic acids, amino acids, fatty acids, and biogenic amines, including elevation of butyric acid at onset of NE in broiler chickens. Subsequent analysis of broilers infected with CP isolates with different toxin gene combinations confirmed an elevation of butyric acid consistently among 21 differentially expressed metabolites including organic acids, amino acids, and biogenic amines, underscoring its potential role during the development of NE. Furthermore, protein-metabolite network analysis revealed significant alterations in butyric acid and arginine-proline metabolisms.

Conclusion

This study indicates a significant metabolic difference between CP-infected and non-infected broiler chickens. Among all the metabolites, butyric acid increased significantly in CP-infected birds compared to non-infected healthy broilers. Logistic regression analysis revealed a positive association between butyric acid (coefficient: 1.23, P < 0.01) and CP infection, while showing a negative association with amino acid metabolism. These findings suggest that butyric acid could be a crucial metabolite linked to the occurrence of NE in broiler chickens and may serve as an early indicator of the disease at the farm level. Further metabolomic experiments using different NE animal models and field studies are needed to determine the specificity and to validate metabolites associated with NE, regardless of predisposing factors.
Quantification of pulmonary edema using automated lung segmentation on computed tomography in mechanically ventilated patients with acute respiratory distress syndrome
Authors: Conrad Alice Marguerite , Zimmermann Julia , Mohr David , Froelich Matthias F. , Hertel Alexander , Rathmann Nils , Boesing Christoph , Thiel Manfred , Schoenberg Stefan O. , Krebs Joerg , Luecke Thomas , Rocco Patricia R. M. , Otto Matthias
Published: November 2024

Background

Quantification of pulmonary edema in patients with acute respiratory distress syndrome (ARDS) by chest computed tomography (CT) scan has not been validated in routine diagnostics due to its complexity and time-consuming nature. Therefore, the single-indicator transpulmonary thermodilution (TPTD) technique to measure extravascular lung water (EVLW) has been used in the clinical setting. Advances in artificial intelligence (AI) have now enabled CT images of inhomogeneous lungs to be segmented automatically by an intensive care physician with no prior radiology training within a relatively short time. Nevertheless, there is a paucity of data validating the quantification of pulmonary edema using automated lung segmentation on CT compared with TPTD.

Methods

A retrospective study (January 2016 to December 2021) analyzed patients with ARDS, admitted to the intensive care unit of the Department of Anesthesiology and Critical Care Medicine, University Hospital Mannheim, who underwent a chest CT scan and hemodynamic monitoring using TPTD at the same time. Pulmonary edema was estimated using manually and automated lung segmentation on CT and then compared to the pulmonary edema calculated from EVLW determined using TPTD.

Results

145 comparative measurements of pulmonary edema with TPTD and CT were included in the study. Estimating pulmonary edema using either automated lung segmentation on CT or TPTD showed a low bias overall (− 104 ml) but wide levels of agreement (upper: 936 ml, lower: − 1144 ml). In 13% of the analyzed CT scans, the agreement between the segmentation of the AI algorithm and a dedicated investigator was poor. Manual segmentation and automated segmentation adjusted for contrast agent did not improve the agreement levels.

Conclusions

Automated lung segmentation on CT can be considered an unbiased but imprecise measurement of pulmonary edema in mechanically ventilated patients with ARDS.