bluuebunny/crossref_metadata_2025 huggingface dataset:
Islamic Bioethics: Codes of Medical Ethics
Authors: Malik Aisha
Published: May 2024

The evolution of Islamic medical ethics codes and treatises began with the akhlāq and adab treatises, followed by the codes developed by the Islamic Organization for Medical Sciences (IOMS). Akhlāq and adab approximate the meaning of ethics. Akhlāq refers to one’s character, while adab literally means civility or etiquette and refers to norms of right conduct, which are often understood as “one’s disposition as formed by habit.” Though an official code of ethics was absent in the early years of Islam, a small group of conscientious physicians, concerned with the quality of medical care and the reputation of their profession, provided guidelines for individual physicians’ professional behavior. These include Adab–al Ţabīb (The Practical Ethics of the Physician), the Akhlāq -al-Ţabīb (Medical Ethics), and al-Qānūn Fi’l-Tibb (Canon of Medicine). Other important ethics codes include the Islamic Code of Medical Ethics, the International Islamic Code for Medical and Health Ethics, and the Islamic Code of Medical and Health Ethics.
Relics and Pilgrimage in Western Europe
Authors: Snyder Janet Ellen
Published: May 2024

Relics, pilgrimage, miraculous occurrences, the visual arts, architecture, and patronage were closely intertwined western Christendom from the earliest period through the later Middle Ages. Relics have been venerated not only in Christianity but also in many other religions, including Islam and Buddhism. Due to the complex relationship between religious conviction, physical objects, precious materials and containers, wars and political alliances, economic and territorial interests, and the explosion in the number of pilgrimage centers in Western Europe, this brief study of relics, pilgrims, and pilgrimage must be limited to mainstream Latin Christianity, primarily from the later Middle Ages until the Protestant Reformation. Background will be provided to flesh out the special nature of the content. The profound influence on the visual arts of pilgrimage and the veneration of relics is apparent in various aspects of this study: the relics themselves and their containers; reasons and motivations for pilgrimage in the later Middle Ages; accommodations for visitors in churches and along the routes of pilgrimage.

Visual arts and architecture supported the honor and veneration of holy beings and holy sites by pilgrims at reliquary shrines, with textiles, special containers, and altar vessels; painted and gilded exterior and interior sculpture programs made of stone or wood; painted stained-glass windows and wall paintings; and church furnishings. Grand and spacious churches with many formal similarities were constructed during the later Middle Ages along each route followed by pilgrims from Northern Europe to Jerusalem, Rome, and Santiago de Compostela. The development of church plans and the proliferation of chapels around the choir reveal the impact of pilgrimage and the relics pilgrims sought to visit.

Pilgrims undertook their arduous journeys for various reasons. Upon setting out, pilgrims usually intended to return home, though the dangers and difficulties meant that many were unable to do so. Pilgrims obtained authorization from their local bishop to be given hospitality and to be accommodated on their journeys. The later Middle Ages witnessed an explosion in the numbers of participants in extended journeys as well as in local pilgrimages, in all regions of Europe. Thefts and translations as well as pious donations brought a proliferation of relics and reliquaries. The needs of pilgrims—for shelter and sustenance, nourishment and healthcare, and well-maintained roads, bridges, and ferry crossings—meant that the architectural amenities provided in response to pilgrimage had a powerful international impact in the places they visited and upon the homelands to which they returned. The influences not only of souvenirs brought home but also of the pilgrim’s life experience on the visual arts and architecture are complex and have been long-lasting.
ordo matronarum
Authors: Webb Lewis
Published: May 2024

The ordo matronarum (order of married women) was a corporate body of married women (matronae) in Rome, attested for the Republic and Principate. Its exact composition is uncertain, but accounts of its activities in the Republic suggest its members included wealthy, high-status married women and widows. Criteria for membership probably included a marriage, substantial wealth, and high status: this was an exclusive ordo. It was thus analogous to the ordo equester.

The ordo matronarum may have existed already by the 3rd century bce, given the evidence of Plautus and Livy. By 42 bce, the ordo included perhaps 1,400 wealthy married women, as attested by Valerius Maximus and Appian. The evidence from Seneca and Suetonius indicates it persisted in some form into the Principate.

Matronae were distinguished by privileges and status symbols (vehicles, mobility privileges, funerary orations, jewellery, dress): they had a visible, corporate identity. The ordo matronarum was feasibly one of the primary structures behind the collective actions of married women attested in the Republic and the Principate, facilitating meetings, collections, benefactions, lobbies, mourning, religious activity, and more. Epigraphic evidence of matronal dedications, benefactions, mourning, and corporate bodies from Italy from the 3rd century bce to the 3rd century ce offers corroborating support for the existence of the ordo matronarum.

Since the key studies of Jean Gagé, Nicholas Purcell, and Emily Hemelrijk in the second half of the 20th and early 21st centuries, scholars have increasingly recognized the prominence and participation of the ordo matronarum in Roman society. Studies in the early 21st century further evince matronal engagement and integration in the religious and political life of Rome.
Greco-Roman architecture, reception of
Authors: Macaulay Elizabeth R.
Published: May 2024

Since antiquity Greek and Roman architecture has been subject to diverse and complex receptions. Architectural forms have experienced different and wide-scale transformations across space and time, both in antiquity and in postantique contexts. These adapted forms have emerged because of the complex interactions between building traditions and contemporary needs.
Dislocation in the Romance Languages: Syntax, Semantics, Discourse, Acquisition
Authors: Garassino Davide
Published: May 2024

Dislocations are syntactic constructions consisting of a core sentence and a detached constituent located outside the clause, either at its left (left dislocation) or at its right (right dislocation). Typically, although not invariably, the clause hosts a resumptive element, often a pronoun, which is co-referent with the detached constituent. This separation between an extra-clausal element and the sentence led to the classification of dislocations as “non-canonical” or “marked” syntactic structures.

Dislocations are attested in many language families, to the extent that they can be regarded as a language universal. However, these constructions have predominantly been examined in Germanic and Romance languages, both in formal and functional frameworks.

Left and right dislocations are usually analyzed as topic-marking structures, in which the referent of the detached element has the function of sentence topic. However, specific types of topics appear to preferentially occur in either left or right dislocation. For example, left dislocations often convey topic shifts and contrastive topics, while continuous (or familiar) topics are more commonly found in right dislocations. Nonetheless, corpus-based research unveiled a more nuanced situation. Furthermore, interactionally oriented studies also suggest that exploring dislocations in spontaneous conversations is crucial for comprehending their broad functional spectrum.

Thus, dislocations present many intriguing challenges to Romance linguistics, including the questions, To what extent do left and right dislocations differ syntactically and pragmatically across Romance languages? Are descriptions framed in terms of “topic establishing” and “topic promotion” truly adequate? What are the main prosodic characteristics of left and right dislocations? and What challenges do L1 and L2 learners encounter in the acquisition of these constructions?
Intonation in the Romance Languages
Authors: Gili Fivela Barbara
Published: May 2024

The article discusses the main intonation features of Catalan, French, Italian, Occitan, Portuguese, Raeto-Romance, Romanian, Sardinian, and Spanish, even though they have been investigated to different extents for their intonation traits. Differing amount of research has been carried out on each individual language, this research has often been performed with different methods and with reference to different frameworks, and, finally, investigations have considered language dialects and varieties in a variety of ways.

Nevertheless, scientific literature on intonation in Romance languages, especially that which refers to the autosegmental–metrical framework, has highlighted similarities and differences regarding prominence, phrasing, and the relationship between intonation patterns and pragmatic meaning. Pitch prominence is attested in all languages and varieties, whether it is related to lexical stressed positions or accentual phrases (APs), and the nuclear prominence does not need to be implemented on the rightmost element; consistently, Romance languages usually show pitch-range compression rather than de-accenting in statements. As for phrasing, most languages and varieties feature at least two levels above the word (the intonational phrase [IP] and the intermediate phrase [ip]), while some languages and varieties also feature a third level in the prosodic hierarchy (the AP), and one variety has one level only (the IP). Regarding pitch patterns, languages and varieties show a highly variable number of nuclear contours and internal variation; these, however, largely depend on the sentence type; this is because variation tends to be greater in questions than in broad-focus statements, where the usual pattern a falling one Romance languages.

The article’s final remarks focus on open issues, such as the debates on pitch-accent density and the prosodic levels, with a specific reference to the ip constituent and to constituents larger than the IP. Additionally, it addresses the need for larger comparable corpora, collected by means of the same methods and transcribed with reference to the same framework, as well as for a wider perspective which also takes into account the integration of context and multimodal information, in order to deepen the current body of knowledge on intonation in the Romance languages.
Gothic and Other East Germanic Varieties
Authors: Schaffner Stefan
Published: May 2024

Biblical Gothic is the earliest Germanic language preserved in a longer text. The main source is represented by the Bible translation of the Visigothic Arian Christian bishop Wulfila ( born ca. 311, deceased ca. 382–383). Another few short Gothic texts are extant. For the translation of the Bible (ca. 350–380), on the basis of a Greek text, Wulfila invented his own alphabet (called Wulfila’s alphabet), using the Greek alphabet as model, with the addition of Latin and runic characters. Several manuscripts (5th/6th century; the most famous is the Uppsala Codex argenteus) contain the greater part of the New Testament. In spite of its fragmentary documentation, Gothic represents without doubt an important basis for the reconstruction of Proto-Germanic, because it offers—due to its early attestation—very archaic features in all areas of its grammar in comparison with the other old Germanic languages, the documentation of which began some centuries later. Gothic also shows recent innovations (especially the almost complete elimination of the effects of Verner’s Law within the strong verbs). The position of Gothic within the other Germanic subgroups, North and West Germanic, is still a matter of controversial discussion. Whereas older research stressed the correspondences between Gothic and North Germanic and, therefore, favored a closer relationship between them, postulating a subgroup Goto-Nordic, currently, a subgrouping into Northwest Germanic on the one hand and East Germanic (with Gothic as the most important representative) one the other hand is preferred, although this model also leaves open a couple of questions, giving impetus to further research. Other varieties of East Germanic are runic epigraphic texts (less than 10, most of them probably Gothic) from the 1st half of the 3rd century until the end of the 6th century. One of them (on the Charnay fibula, 2nd half of the 6th century) is probably of Burgundian origin. The documentation of other EGrm (East Germanic). languages is very poor and consists almost only of a few names. Two short syntagmata can probably be attributed to Vandalic. Crimean Gothic, the latest attested EGrm. language, is documented in a list of several dozen words and three lines of a cantilena. Most attested forms seem to represent a late EGrm. dialect.
Nominal Inflectional Morphology in Germanic: Nouns
Authors: Zimmer Christian
Published: May 2024

The modern Germanic languages encode up to three categories on nouns: number (with the values singular and plural), case (with up to four values: nominative, accusative, dative, and genitive), and definiteness (with the values definite and indefinite). The variation within this branch of the Indo-European language family is immense: While, for example, Icelandic encodes all three categories and all the values mentioned, English differentiates only between singular and plural via the inflection of nouns. Such differences in the number of categories that are encoded on nouns are due to the grammaticalization of postnominal articles into bound definiteness markers in the North Germanic languages, which has not taken place in the other Germanic languages, and the loss of case (e.g., in English and most, but not all, other Germanic languages). Furthermore, Germanic languages differ greatly in how number and case are encoded. Firstly, the coding techniques suffixation, stem modulation, subtraction, tone, and combinations of these techniques (plus zero marking) vary in frequency across the languages at hand. Secondly, case and number can be expressed within a cumulative formative (this is the case in Icelandic and Faroese) or with the help of separate formatives. Thirdly, the extent to which allomorphy can be observed varies considerably—ranging from virtually no allomorphy in English (with -s and phonologically determined variants as the only formative) to intricate systems in Icelandic and Faroese. And fourthly, allomorphs are assigned according to different principles, with phonology (both segmental and suprasegmental), semantics, and grammatical gender being of varying importance.
Suprasegmental Phenomena in Germanic: Tonal Accent
Authors: Iosad Pavel
Published: May 2024

Several Germanic varieties possess a phonological contrast usually referred to as “tonal accent.” They demonstrate phonological contrasts between words that are otherwise identical in their segmental make-up and the location of stress, as in (Urban East) Norwegian bønder ‘farmers’ and bønner ‘beans’, both segmentally [ˈbønːər]. Usually, the contrast is treated as implemented by pitch trajectories; hence, the name 'tonal accent.' Within Germanic, tonal accent contrasts are found in three (historically, perhaps four) areas. First, they occur in most varieties of Norwegian and Swedish, as well as in some Danish dialects; in addition, most varieties of Danish show a peculiar type of accentual distinction based on laryngealization, traditionally known as stød. Second, they are found in a set of West Germanic dialects along the middle Rhine and the Moselle, the so-called Franconian tonal area. Third, they are reported from many varieties of Low German, specifically North Low Saxon. Finally, they may have been present historically in Frisian.

Three aspects of Germanic tonal accent systems are of particular interest to linguistic theory. In terms of synchronic analysis, accents have been considered as sui generis objects, as fundamentally tonal phenomena, and as artifacts of contrasts in metrical (foot) structure and its mapping to intonation. Diachronically, Germanic accents are a poor fit to the cross-linguistic typology of tonogenesis: their development is intimately tied to processes manipulating metrical structures, such as vowel lengthening, syllable deletion and insertion, and clash resolution. Finally, they offer some enlightening case studies with respect to the role of language contact in the development of prosodic systems.
Bridging Risk Communication and Health Literacy to Improve Health Outcomes Related to Heat
Authors: VanderMolen Kristin , Hatchett Benjamin
Published: May 2024

Extreme heat, whether occurring as single or multiple anomalously hot days and nights, poses direct and indirect impacts to human health and to built and natural systems. Direct impacts include heat-related illnesses (e.g., heat cramps, heat exhaustion, heatstroke) and mortality. Indirect impacts include exacerbations of other hazards, like drought and wildfire, as well as stressors like air pollution. Adaptation to extreme heat can take many forms, such as in behavioral, institutional, infrastructural, technological, and ecosystem-based change. It can also take place on varying levels or spatial scales, requiring different resources and time frames to implement. Given that heat-related illnesses and mortality are often preventable when people are able to take protective action, one potentially near-term, relatively cost-efficient, and effective adaptation is to successfully inform the public about heat risk. This requires not only communicating with the public about heat risk when it is imminent (i.e., institutional adaptation), but also educating the public about heat risk such that it can interpret and make use of the messaging received (i.e., behavioral adaptation). The field of risk communication offers recommendations and guidance that can help inform heat risk communication, for example related to warning source and channel as well as to message purpose, content, and style. Similarly, the field of health literacy, and in particular the newly conceptualized “climate and health literacy,” offer proposed pathways that can be leveraged to help educate the public about heat risk. Bridging these two fields and the actors (or practitioners) within them therefore promises to be fruitful in the reduction of heat-related morbidity and mortality and in improving overall health outcomes in vulnerable populations across the globe. Critically, however, to be effective, both risk communication and climate and health literacy must be designed with direct knowledge of and engagement with target audiences. Accordingly, actors within these fields should collaborate not only with one another but also with the specific audiences they intend to serve.
Housing Deficit and Disaster Risk Management in Chile
Authors: Ponce Arancibia Natalia
Published: May 2024

The housing deficit, which affects especially the most vulnerable sectors, corresponds to a constant and growing challenge for housing policies developed in the Chilean context. Its provision presents complexities that respond, to a large extent, to the availability and high values of land as a result of market deregulation. The demand for new housing, in this sense, has been resolved under two mechanisms: through irregular land occupations and self-construction of housing, and through state action and the implementation of programmatic devices for the construction of new residential complexes. Housing developments or settlements are generally located on the margins of urbanized territory—that is, in sectors where land transaction costs are lower due, in part, to possible conditions of risk or territorial vulnerability. These conditions are strongly expressed in the housing configuration and spatial location patterns that characterize the commune of Alto Hospicio, located in the Tarapacá Region in northern Chile. In this commune, whether due to the spontaneous action of the inhabitants or the action of state institutions, housing intended for socially vulnerable sectors is exposed to conditions that can lead to significant losses of residential assets and affect the living conditions of their inhabitants.
The Development Path of Urban Water and Sanitation Tariffs and Subsidies: A Conceptual Framework
Authors: Whittington Dale , Wishart Marcus , Kaczan David , Wang Hua , Liao Xiawei , Gou Si
Published: May 2024

The provision of universal, high-quality piped water and sanitation services on a financially sustainable basis continues to elude many urban areas globally. Water services suffer from political, technical, and financial “disequilibria,” in which governments are challenged to improve services, households are unwilling or unable to pay to cover the increased costs associated with those services, and both production and consumption efficiency remains low due to insufficient capital investment, low operating budgets, and poorly designed tariffs. Cities typically move along a water development path from low- to high-quality service provision, with movement between phases facilitated by shifts in these disequilibria. In the first phase, water supply coverage increases but quality of service and efficiency of consumption and production stagnates, trapped by insufficient government transfers and low tariffs. In the second phase, economic growth facilitates increased revenues, allowing for investments in service quality and increasing access to improved sanitation. Production efficiency improves, but consumption efficiency remains low due to weak price signals and poorly targeted subsidies, and environmental quality often degrades. In the third phase—which remains aspirational for many cities—governments and citizens demand improved environmental quality as well as improved service quality. Investments are made to improve the resilience of supply, and subsidies are more carefully targeted toward the poor. China demonstrates many of these patterns, with variation across cities reflecting different levels of development. There are, however, some differences that are a consequence of the country’s centrally planned economy prior to 1978. Reforms underway in China highlight the challenges of achieving this “third phase” urban water policy. These include revisions to the existing increasing block tariffs to improve financial sustainability, increased use of information provision to improve consumption efficiency, and asset management and investment planning that weighs the benefits and costs of new capital investments in the context of climate change.
Kivnick, Helen
Authors: Adams-Price Carolyn E.
Published: May 2024

Helen Kivnick (1950–2020) was a clinical psychologist and social worker at the University of Minnesota. Her early research was on the meaning of grandparenthood to grandparents, which inspired her interest in working with older adults. Kivnick became well known for her work with Erik and Joan Erikson, where she helped them to revise Erik Erikson’s theory of life-span development by changing the oldest stage of development from emphasizing reminiscence to emphasizing vital involvement in life, which is defined as finding meaningful ways to interact creatively with other people. Vital involvement was a major theme in her life’s work. Kivnick was also a musician interested in social justice, and in the 1980s, she visited South Africa to study and promote the choral music of Black South Africans during apartheid. She produced two albums of African music and was nominated for a Grammy for one of them. Kivnick was known for her belief that even frail elders can lead meaningful lives and be role models for younger folks. She was also a promoter of the arts. With Linda Davis, she developed arts and strength-related interventions to improve health and well-being in at-risk inner city young adults and frail older adults. Finally, she believed that the humanities and arts were important means of understanding the meaning of late life. She increased the visibility of the arts and humanities as the first associate editor for the Humanities and Arts section of The Gerontologist, the flagship journal of the Gerontological Society of America.

Helen Kivnick was a woman who was able to integrate her different interests into one marvelous career. She was a clinical psychologist, a gerontologist, a social worker, a musician, and a patron of the arts. She was equally interested in theory about adult development and aging and in practical methods to improve older adults’ lives. She was also proficient in both qualitative and quantitative research. Although best known for her early work with Erik and Joan Erikson, her contributions expand upon and go far beyond the early work.
When Epistemic Models Misfire: Lessons for Everyday Rationality
Authors: Sturgeon Scott
Published: May 2024

Three natural assumptions about rationality lead to conflict when they are formalized in natural ways. The paper examines how the assumptions are built into formal frameworks and why they lead to conflict. Several lessons are learned for the type of rationality ordinary people manifest in everyday life.
Archerfish foraging success varies with immediate competition level but not group size
Authors: der Weduwen Dagmar , Jones Nick A R , Dubosque Adèle , Schuster Stefan , Sillar Keith T , Webster Mike , Rendell Luke
Published: May 2024

Group living can lead to kleptoparasitism, the theft of resources by competitors. Under such conditions, foragers may alter their behavior to minimize competition. However, it is unclear how such behavioral changes impact foraging performance. Archerfish (Toxotes spp.) are a good model for investigating the behavioral responses to kleptoparasitism, as their hunting method (shooting waterjets at insects perched above the water) leaves them vulnerable to theft. They must hit the target prey with sufficient force to dislodge it; thus, the prey may land some distance away from the shooter. Kleptoparasitism rates increase with group size in archerfish, and individuals alter their behavior around conspecifics. We investigated whether group size affected shooting success, using 7-spot archerfish T. chatareus. We considered a fish’s shot to be successful if it knocked a fly, placed on a transparent platform above the tank, into the water. The probability of shooting success was modeled as a function of group size, aiming duration, nearest neighbor distance and position, and trial number. We found no effect of group size, aiming duration, or nearest neighbor distance or position on shooting success. Shooting success increased as trials progressed, likely due to the fish becoming more familiar with the task. We also found no change in the kleptoparasitism rate between group sizes. Instead, the likelihood of the shooter consuming the prey depended on the types of competition present at the time of shooting. We suggest that archerfish shooting behavior can be influenced by the presence of conspecifics in ways not previously considered.
Normalization of RNA-Seq data using adaptive trimmed mean with multi-reference
Authors: Singh Vikas , Kirtipal Nikhil , Song Byeongsop , Lee Sunjae
Published: May 2024

The normalization of RNA sequencing data is a primary step for downstream analysis. The most popular method used for the normalization is the trimmed mean of M values (TMM) and DESeq. The TMM tries to trim away extreme log fold changes of the data to normalize the raw read counts based on the remaining non-deferentially expressed genes. However, the major problem with the TMM is that the values of trimming factor M are heuristic. This paper tries to estimate the adaptive value of M in TMM based on Jaeckel’s Estimator, and each sample acts as a reference to find the scale factor of each sample. The presented approach is validated on SEQC, MAQC2, MAQC3, PICKRELL and two simulated datasets with two-group and three-group conditions by varying the percentage of differential expression and the number of replicates. The performance of the present approach is compared with various state-of-the-art methods, and it is better in terms of area under the receiver operating characteristic curve and differential expression.
114 CLAUSEWITZ’S “FOG OF WAR” AND THE DIFFICULTY OF ASSESSING THE RISK OF MALIGNANCY OF THYROID NODULES BETHESDA III-IV IN CORRELATION WITH THE EU-TIRADS CLASSIFICATION
Authors: Sola M , Saladich M , Bardaji M , Collera P
Published: May 2024

Background

The management of thyroid nodules is based on the Bethesda and TIRADS classification. We analyzed our results using a correlation of both methods to assess the risk of malignancy (ROM) to show that this estimation is especially uncertain in the thyroid nodules Bethesda III-IV. The issue of uncertainty is not new, the Prussian military theorist, Carl von Clausewitz (1832), studied the psychological aspects of war and provided the term “fog of war”.

Methods

All patients who underwent a total or hemithyroidectomy from January 2022 to November 2023 were included in this study. The results of TIRADS and Bethesda classification were correlated with the pathologic results.

Results

During this period, 218 patients had thyroid surgery. Bethesda group III was associated with a ROM of 41%; in association with a TIRADS 5 the ROM increased to 58%. Bethesda IV had a ROM of 60%, only if combined with TIRADS 5, ROM reached 100%. We found that the ROM was more accurate using the Bethesda combined with the TIRADS classification, especially nodules TIRADS 5; but in Bethesda II and III, despite the TIRADS, the ROM was still very uncertain.

Conclusions

The “fog of war” refers to the diminished level of accuracy of the information provided. According to Clausewitz, “a sensitive and discriminating judgment is called to scent out the truth.” Despite many advances, preoperative cancer risk assessment for most thyroid nodules remains imprecise, and the treatment still depends on the surgeon preferences.
102 THERMAL ABLATION VERSUS TOETVA FOR A SOLITARY BENIGN THYROID NODULE: CHANGING LANDSCAPE OF PATIENTS PREFERENCES IS COMING TRUE
Authors: Barczynski M , Belowski J
Published: May 2024

Background

A changing landscape of patients’ preferences for treatment of solitary and benign thyroid nodules (SBTN) form conventional surgery to other minimally invasive treatments (MITs) has been witnessed. The aim of this study was to evaluate indications, patient’s preferences, and outcomes of conventional surgery vs laser ablation (LA) vs transoral endoscopic thyroid surgery by vestibular approach (TOETVA) treatments for SBTN.

Methods

This prospective cohort study included patients with SBTN causing compression symptoms treated at our institution throughout 2020 - 2023. Primary endpoint was patient’s preferences for treatment. Secondary endpoints were overall morbidity, need for second line treatment, and satisfaction rate.

Results

Some 204 patients (F:M = 161:43) with SBTN were offered conventional surgery (thyroid lobectomy) vs TOETVA vs LA. Patients preferences were: 23 (11.3%) for conventional surgery vs 17 (8.3%) for TOETVA vs 164 (80.4%) for LA (p<0.01). Overall morbidity was 2/23 (8.7%) for conventional surgery vs. 2/17 (11.8%) for TOETVA vs 3/164 (1.8%) for LA (p<0.01). Volume reduction rate (VRR) for LA was 63% (range: 32% - 98%) at 6 months following treatment. Spongiform nodules vs fluid-solid tumors vs solid tumors had VRR of 83% vs 67% vs 51%, respectively (p<0.01). Second line treatment was needed for 3/164 (1.8%) patients following LA within a 3-year follow-up. Satisfaction rate was higher for LA and TOETVA vs conventional surgery (p<0.01).

Conclusions

Currently most patients prefer MITs for SBTN. TOETVA is chosen by minority of patient with a strong motivation to have no scar whereas LA is the preferred MIT nowadays.
Motivated Optimism and Workplace Risk
Authors: Orhun Yeşim , Cohn Alain , Raymond Collin B
Published: May 2024

We provide field evidence that individuals engage in motivated optimism in the face of impending risk. Congruent with a dynamic anticipatory utility model, we demonstrate that belief distortions are time and stake dependent. Our study leverages variation in the time span between the survey and the externally imposed date when workers are required to return to their workplaces during the COVID-19 pandemic. We show that, as the work return date approaches, individuals become relatively more optimistic about the increased infection risk associated with going back to the workplace, and about how severely their health may be impacted if they get infected. Belief distortions are larger among those facing potential health complications conditional on infection. Our results are informative about when and for whom interventions will be most effective.
Nocturnal heat exposure and stroke risk
Authors: He Cheng , Breitner Susanne , Zhang Siqi , Huber Veronika , Naumann Markus , Traidl-Hoffmann Claudia , Hammel Gertrud , Peters Annette , Ertl Michael , Schneider Alexandra
Published: May 2024

Background and Aims

In recent decades, nighttime temperatures have increased faster than daytime temperatures. The increasing prevalence of nocturnal heat exposure may pose a significant risk to cardiovascular health. This study investigated the association between nighttime heat exposure and stroke risk in the region of Augsburg, Germany, and examined its temporal variations over 15 years.

Methods

Hourly meteorological parameters, including mean temperature, relative humidity, and barometric pressure, were acquired from a local meteorological station. A data set was obtained consisting of 11 037 clinical stroke cases diagnosed during warmer months (May to October) between the years 2006 and 2020. The average age of cases was 71.3 years. Among these cases, 642 were identified as haemorrhagic strokes, 7430 were classified as ischaemic strokes, and 2947 were transient ischaemic attacks. A time-stratified case-crossover analysis with a distributed lag non-linear model was used to estimate the stroke risk associated with extreme nighttime heat, as measured by the hot night excess (HNE) index after controlling for the potential confounding effects of daily maximum temperature and other climatic variables. Subgroup analyses by age group, sex, stroke subtype, and stroke severity were performed to identify variations in susceptibility to nighttime heat.

Results

Results suggested a significant increase in stroke risk on days with extreme nighttime heat (97.5% percentile of HNE) (odds ratio 1.07, 95% confidence interval 1.01–1.15) during the full study period. When comparing the results for 2013–20 with the results for 2006–12, there was a significant increase (P < .05) in HNE-related risk for all strokes and specifically for ischaemic strokes during the more recent period. Furthermore, older individuals, females, and patients with mild stroke symptoms exhibited a significantly increased vulnerability to nighttime heat.

Conclusions

This study found nocturnal heat exposure to be related to elevated stroke risk after controlling for maximum daytime temperature, with increasing susceptibility between 2006 and 2020. These results underscore the importance of considering nocturnal heat as a critical trigger of stroke events in a warming climate.
YajC, a predicted membrane protein, promotes Enterococcus faecium biofilm formation in vitro and in a rat endocarditis model
Authors: Top Janetta , Zhang Xinglin , Hendrickx Antoni P A , Boeren Sjef , van Schaik Willem , Huebner Johannes , Willems Rob J L , Leavis Helen L , Paganelli Fernanda L
Published: May 2024

Biofilm formation is a critical step in the pathogenesis of difficult-to-treat Gram-positive bacterial infections. We identified that YajC, a conserved membrane protein in bacteria, plays a role in biofilm formation of the clinically relevant Enterococcus faecium strain E1162. Deletion of yajC conferred significantly impaired biofilm formation in vitro and was attenuated in a rat endocarditis model. Mass spectrometry analysis of supernatants of washed ΔyajC cells revealed increased amounts in cytoplasmic and cell-surface-located proteins, including biofilm-associated proteins, suggesting that proteins on the surface of the yajC mutant are only loosely attached. In Streptococcus mutans YajC has been identified in complex with proteins of two cotranslational membrane protein-insertion pathways; the signal recognition particle (SRP)-SecYEG-YajC-YidC1 and the SRP-YajC-YidC2 pathway, but its function is unknown. In S. mutans mutation of yidC1 and yidC2 resulted in impaired protein insertion in the cell membrane and secretion in the supernatant. The E. faecium genome contains all homologous genes encoding for the cotranslational membrane protein-insertion pathways. By combining the studies in S. mutans and E. faecium, we propose that YajC is involved in the stabilization of the SRP-SecYEG-YajC-YidC1 and SRP-YajC-Yid2 pathway or plays a role in retaining proteins for proper docking to the YidC insertases for translocation in and over the membrane.
Age and growth reductions increase the proportion of dark heartwood in sugar maple at the northern limit of its range
Authors: Voyer David , Moreau Guillaume , Gennaretti Fabio , Bédard Steve , Havreljuk Filip , Grondin Pierre , Achim Alexis
Published: May 2024

The wood of sugar maple (Acer saccharum Marsh.) in the northernmost part of the species range often exhibits high proportions of discoloured wood at the centre of the stems, which is referred to as dark heartwood. This defect significantly decreases the wood market value of the species, which, in turn, challenges the implementation of state-of-the art silvicultural treatments. The causes of dark heartwood are associated with trauma and the colder climate of the northern regions. In this study, we investigate factors influencing the occurrence of dark heartwood in sugar maple’s northern populations, considering tree age, vigour, stem growth, and local climate. We also aimed to determine whether the proportion of dark heartwood is higher in northern stands compared to more southern ones. We collected samples from 302 sugar maple stems at 16 sites within two bioclimatic domains of Quebec, Canada, i.e. the balsam fir–yellow birch domain (representing the northern limit of the sugar maple range) and the sugar maple–yellow birch domain (representing a more southern location within the range). Our results indicate a positive relationship between dark heartwood proportions and stem age, as well as with the amplitude of the maximum growth reduction throughout the tree’s lifespan and the length of the longest suppression period. We also observed significantly higher dark heartwood proportion for a given tree age in northern stands. The results suggest that silvicultural systems aiming to release suppressed crop trees through group selection using a cut-to-length system could favour the development of high quality timber.
Separation of source, attenuation and site parameters of 2 moderate earthquakes in France: an elastic radiative transfer approach
Authors: Heller G , Margerin L , Sèbe O , Mayor J , Calvet M , Traversa P , Latour S
Published: May 2024

An accurate magnitude estimation is necessary to properly evaluate seismic hazard, especially in low to moderate seismicity areas such as Metropolitan France. However, magnitudes of small earthquakes are subject to large uncertainties caused by major high-frequency propagation effects which are generally not properly considered. To address this issue, we developed a method to separate source, attenuation and site parameters from the elastic radiative transfer modelling of the full energy envelopes of seismograms. The key feature of our approach is the treatment of attenuation—both scattering and absorption—in a simple but realistic velocity model of the Earth’s lithosphere, including a velocity discontinuity at the Moho. To reach this goal, we developed a 2-step inversion procedure, allowing first to extract attenuation parameters for each source-station path from the whole observed energy envelope using the Levenberg–Marquardt and grid-search algorithms, then to determine site amplification and the source displacement spectrum from which the moment magnitude Mw is extracted. In the first step, we use the forward modelling procedure of Heller et al. in order to simulate energy envelopes by taking into account the full treatment of wave polarization, the focal mechanism of the source and the scattering anisotropy. The inversion procedure is then applied to the 2019 ML 5.2 Le Teil and 2014 ML 4.5 Lourdes earthquakes which both occurred in southern France. Data from 6 stations are selected for each event. The inversion results confirm a significant variability in the attenuation parameters (scattering and absorption) at regional scale and a strong frequency dependence. Scattering appears to be stronger towards the French Alps and Western Pyrenees. Absorption is stronger as frequency increases. Although not very resolvable, the mechanism of scattering appears to be forward or very forward. By inverting the source spectrum, we determine moment magnitudes Mw of 5.02 ± 0.17 for the Le Teil earthquake and 4.17 ± 0.15 for the Lourdes earthquake.
Towards a coordinated approach for managing accelerated patient access to potentially beneficial medicines: reporting the perspectives of a multi-stakeholder, international workshop
Authors: Phillips Marie , Synnott Patricia , Henshall Chris , Tunis Sean , Sansom Lloyd , Ollendorf Daniel
Published: May 2024

Accelerated and conditional regulatory pathways for drug approvals are intended to enable earlier patient access to potentially life-saving treatments, or treatments that provide benefits in addressing a significant unmet need. However, there are questions about how well such pathways work, how appropriately they are applied, and how the work of regulators can be better coordinated with that of health technology assessment (HTA) and payer bodies, providers and health systems, and other stakeholders. In June 2023, a multi-stakeholder, international workshop was convened in Adelaide, Australia, to deliberate the challenges, goals, and opportunities to improve accelerated access pathways. Workshop attendees included representatives from patient organizations, regulators, HTA/payer bodies, universities (ethicists, health economists), and companies developing and marketing new medicines from Australia, Asia, Europe, and North America. We reviewed the contents of this workshop to identify areas of agreement and disagreement, report the key themes of the discussion, and delineate next steps for improving accelerated access pathways. We found that there was general agreement among workshop attendees that accelerated access could be improved significantly by strengthening processes for stakeholder coordination, and that coordinated efforts will be required to implement meaningful change moving forward.
Access to insurance navigation support through the State Health Insurance Assistance Program (SHIP)
Authors: Garrido Melissa M , Biko David , Dorneo Allison , Shafer Paul R , Frakt Austin B
Published: May 2024

Medicare enrollment is complex, particularly for low-income individuals who are dually eligible for Medicare and Medicaid, and the wrong plan choice can adversely impact beneficiaries’ out-of-pocket costs and access to providers and medications. The State Health Insurance Assistance Program (SHIP) is a federal program that provides counseling on Medicare coverage, but the degree to which SHIP services are accessible to low-income beneficiaries is unknown. We interviewed SHIP counselors and coordinators to characterize factors affecting access to and quality of SHIP services for low-income beneficiaries. Availability of volunteers was cited as the primary barrier to SHIP services. Topics related to dual eligibility for Medicare and Medicaid were frequently covered in counseling sessions, and staff expressed a desire for more training related to Medicaid and integrated-care programs. Our results suggest that additional counselors and increased training on topics relevant to dually eligible individuals may improve SHIP's ability to provide health insurance–related information to low-income Medicare beneficiaries.
Does Phenotypic Integration Promote Convergent Evolution?
Authors: Stayton C Tristan
Published: May 2024

Synopsis

Phenotypic integration is often perceived as being able to produce convergent evolution in the absence of selection, but specific mechanisms for this process are lacking and a connection has never been empirically demonstrated. A new model of the effect of integration on convergence provides such a mechanism, along with other predictions about the influence of integration on evolutionary patterns. I use simulations and data from three empirical systems—turtle shells, characiform fish, and squirrel mandibles—to investigate the degree to which evolutionary integration is associated with high levels of convergent evolution. Levels of integration were varied in Brownian motion simulations and the resulting amounts of stochastic convergent evolution were quantified. Each empirical system was divided into modules, and the strength of integration, average amount of convergence, phenotypic disparity, and rate of evolution in each module were measured. Results from the simulations and from all three empirical systems converge on a common result: higher levels of phenotypic integration are indeed associated with higher levels of convergence. This is despite a lack of consistent association between the strength of phenotypic integration and evolutionary rate or disparity. The results here are only correlational. Further studies that more closely examine the influence of within-population drivers of evolutionary integration—for example, genetic or developmental integration—on convergence are required before it is possible to definitively establish when phenotypic integration can cause evolutionary convergence. Until then, however, the results of this study strongly suggest that phenotypic integration will often promote convergent evolution.
Anterior–Posterior Wnt Signaling Network Conservation between Indirect Developing Sea Urchin and Hemichordate Embryos
Authors: Fenner Jennifer L , Newberry Callum , Todd Callie , Range Ryan C
Published: May 2024

Synopsis

How animal body plans evolved and diversified is a major question in evolutionary developmental biology. To address this question, it is important to characterize the exact molecular mechanisms that establish the major embryonic axes that give rise to the adult animal body plan. The anterior–posterior (AP) axis is the first axis to be established in most animal embryos, and in echinoderm sea urchin embryos its formation is governed by an integrated network of three different Wnt signaling pathways: Wnt/β-catenin, Wnt/JNK, and Wnt/PKC pathways. The extent to which this embryonic patterning mechanism is conserved among deuterostomes, or more broadly in metazoans, is an important open question whose answers could lead to a deeper appreciation of the evolution of the AP axis. Because Ambulacrarians (echinoderms and hemichordates) reside in a key phylogenetic position as the sister group to chordates, studies in these animals can help inform on how chordate body plans may have evolved. Here, we assayed the spatiotemporal gene expression of a subset of sea urchin AP Wnt patterning gene orthologs in the hemichordate, Schizocardium californicum. Our results show that positioning of the anterior neuroectoderm (ANE) to a territory around the anterior pole during early AP formation is spatially and temporally similar between indirect developing hemichordates and sea urchins. Furthermore, we show that the expression of wnt8 and frizzled5/8, two known drivers of ANE patterning in sea urchins, is similar in hemichordate embryos. Lastly, our results highlight divergence in embryonic expression of several early expressed Wnt genes (wnt1, wnt2, and wnt4). These results suggest that expression of the sea urchin AP Wnt signaling network is largely conserved in indirect developing hemichordates setting the foundation for future functional studies in S. californicum.